US20180221230A1 - Distraction frame for effecting hip distraction - Google Patents
Distraction frame for effecting hip distraction Download PDFInfo
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- US20180221230A1 US20180221230A1 US15/890,124 US201815890124A US2018221230A1 US 20180221230 A1 US20180221230 A1 US 20180221230A1 US 201815890124 A US201815890124 A US 201815890124A US 2018221230 A1 US2018221230 A1 US 2018221230A1
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- distraction
- patient
- floor
- mount
- table mount
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/0036—Orthopaedic operating tables
- A61G13/0081—Orthopaedic operating tables specially adapted for hip surgeries
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/04—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
- A61F5/04—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints
- A61F5/042—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints for extension or stretching
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- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
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- A61G13/04—Adjustable operating tables; Controls therefor tiltable around transverse or longitudinal axis
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- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
- A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
- A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
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- A61G13/00—Operating tables; Auxiliary appliances therefor
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- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
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- A61B17/025—Joint distractors
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- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0275—Joint distractors for the hip
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- A—HUMAN NECESSITIES
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
- A61F5/37—Restraining devices for the body or for body parts, e.g. slings; Restraining shirts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G2210/00—Devices for specific treatment or diagnosis
- A61G2210/50—Devices for specific treatment or diagnosis for radiography
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- A—HUMAN NECESSITIES
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- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G7/00—Beds specially adapted for nursing; Devices for lifting patients or disabled persons
- A61G7/002—Beds specially adapted for nursing; Devices for lifting patients or disabled persons having adjustable mattress frame
- A61G7/005—Beds specially adapted for nursing; Devices for lifting patients or disabled persons having adjustable mattress frame tiltable around transverse horizontal axis, e.g. for Trendelenburg position
Definitions
- This invention relates to medical apparatus in general, and more particularly to medical apparatus for effecting hip distraction.
- hip distraction When performing surgical procedures on the hip joint, it is common to distract the hip joint prior to the surgery in order to provide additional room within the hip joint during the surgery and in order to better present selected anatomy to the surgeon.
- This hip distraction is commonly achieved by applying a distraction force to the distal end of the leg of the patient.
- a surgical boot is placed on the foot and lower leg of the patient, the surgical boot is connected to a distraction frame, and then the distraction frame is used to apply a distraction force to the surgical boot, whereby to apply a distraction force to the leg of the patient, whereby to distract and position the hip joint.
- the present invention is intended to provide a new and improved distraction frame for applying a distraction force to the leg of the patient so as to effect hip distraction and to allow for leg positioning.
- the present invention provides a new and improved distraction frame for applying a distraction force to the leg of the patient so as to effect hip distraction and to allow for leg positioning.
- a distraction frame for use with a surgical table, wherein the surgical table comprises a base for positioning on a floor, the distraction frame comprising:
- a table mount for fixation to the base of the surgical table
- At least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient;
- the table mount is configured to transfer to the floor a force moment imposed on the table mount when the at least one distraction mechanism applies a distraction force to a limb of a patient.
- a method for distracting a limb of a patient comprising:
- the surgical table comprises a base for positioning on a floor
- the distraction frame comprising:
- a distraction frame comprising:
- At least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient;
- the table mount comprises a surface for selectively contacting the floor, and further wherein the table mount comprises at least one wheel for selectively supporting the surface of the table mount above the floor;
- the at least one horizontal strut comprises at least one caster for selectively rollably supporting the at least one horizontal strut on the floor, and further wherein the table mount comprises at least one foot peg for selectively supporting the at least one caster above the floor;
- the distraction frame can be moved to the surgical table supported by the at least one wheel and the at least one caster, and (ii) the distraction frame can be fixed adjacent to the surgical table supported by the surface of the table mount and the at least one foot peg.
- FIGS. 1 and 2 are schematic views showing a novel distraction frame formed in accordance with the present invention
- FIGS. 3-14 are schematic views showing details of the table mount of the novel distraction frame shown in FIGS. 1 and 2 ;
- FIG. 14A is a schematic view showing how a distraction force applied to the leg of a patient creates a force moment at the table mount which is transferred to the operating room floor;
- FIG. 14B is a schematic view showing a foot pedal mechanism which may be used in place of the adjustable supports of the table mount shown in FIGS. 3-14 ;
- FIGS. 15, 15A-15C, 16-21, 21A-21C and 22-27 are schematic views showing details of the adjustable horizontal struts, the adjustable vertical struts, and elements attached to these struts, of the novel distraction frame shown in FIGS. 1 and 2 ;
- FIGS. 28, 29, 29A-29C and 30-33 are schematic views showing further details of the adjustable vertical struts (and elements attached to these struts) of the novel distraction frame shown in FIGS. 1 and 2 ;
- FIGS. 34 and 35 are schematic views showing how the novel distraction frame of FIGS. 1 and 2 can be positioned in transport mode for movement about a facility;
- FIG. 36 is a schematic view showing how table tilt can be used to influence distraction after a patient's leg has been secured to a distraction frame.
- FIG. 37 is a schematic view showing another novel distraction frame formed in accordance with the present invention, wherein the distraction frame comprises a leg rest for supporting the non-operative leg of a patient.
- the present invention provides a new and improved distraction frame for applying a distraction force to the leg of a patient so as to effect hip distraction.
- FIGS. 1 and 2 there is shown a novel distraction frame 5 formed in accordance with the present invention.
- a surgical table 10 for supporting a patient during surgery, wherein surgical table 10 comprises a base 15 , and (ii) a pair of surgical boots 20 for disposition on the feet and lower legs of the patient.
- Surgical table 10 may be of the sort well known in the art.
- Surgical boots 20 may be the novel surgical boots shown in the aforementioned FIGS. 1 and 2 and described and illustrated in detail in co-pending U.S. patent application Ser. Nos. 62/455,154 (Attorney's Docket No.
- FIAN-118 PROV FIAN-118 PROV
- 62/546,629 Attorney's Docket No. FIAN-124 PROV
- Ser. No. 15/889,998 Attorney's Docket No. FIAN-118124
- surgical boots 20 may be conventional surgical boots of the sort well known in the art.
- surgical table 10 may also comprise a novel table extender 23 which is configured to be mounted to the foot of surgical table 10 , whereby to provide additional support for the patient during a surgical procedure.
- Novel table extender 23 is preferably substantially radiolucent, so that X-ray imaging can be conducted on anatomy supported by novel table extender 23 .
- Novel table extender 23 is described and illustrated in detail in co-pending U.S. patent application Ser. Nos. 62/455,143 (Attorney's Docket No. FIAN-122 PROV), 62/546,600 (Attorney's Docket No. FIAN-125 PROV) and Ser. No. 15/890,047 (Attorney's Docket No. FIAN-122125).
- table extender 23 may comprise a distraction post 24 , which is the traditional means for facilitating hip distraction (e.g., by providing counter-traction to stabilize the patient on the surgical table and by levering the upper end of the leg of the patient against the distraction post so as to dislocate the femoral head from the acetabular cup).
- distraction posts are well known in the art of hip distraction.
- Distraction frame 5 generally comprises a table mount 25 , a pair of adjustable horizontal struts 30 and a pair of adjustable vertical struts 35 .
- Table mount 25 ( FIGS. 1-14 ) generally comprises a body 40 and an extension assembly 43 .
- Body 40 generally comprises a vertical surface 45 , a horizontal surface 50 and a recess 53 .
- Vertical surface 45 of body 40 is intended to sit adjacent to, but slightly spaced from, base 15 of surgical table 10 .
- vertical surface 45 of body 40 may be in contact with base 15 of surgical table 10 .
- vertical surface 45 of body 40 may be set a distance off base 15 of surgical table 10 . Note that the ability to space vertical surface 45 of body 40 from base 15 of surgical table 10 can be advantageous, since it allows distraction frame 5 to work with a wide range of surgical tables.
- Horizontal surface 50 of body 40 is intended to engage the operating room floor during hip distraction.
- Recess 53 is intended to receive a retractable wheel assembly 205 , wherein retractable wheel assembly 205 is configured for selectively (i) projecting out of recess 53 so as to engage the floor and movably support body 40 of table mount 25 above the floor, such that distraction frame 5 may be moved about a facility (for example, to move distraction frame 5 to another operating room or to a storage area), and (ii) retracting into recess 53 so as to disengage from the operating room floor and lower horizontal surface 50 of body 40 onto the operating room floor so as to prevent movement of distraction frame 5 (e.g., during a surgery).
- retractable wheel assembly 205 generally comprises a mount 210 for mounting to body 40 of table mount 25 ( FIGS. 6 and 8 ), and a base 215 movably mounted to mount 210 .
- a spring 220 spring biases base 215 upward into the interior of mount 210 .
- An axle 225 supporting wheels 230 , passes through base 215 .
- An actuation lever 235 together with a linkage 240 and a bar 245 , cooperate with a recess 250 ( FIG. 11 ) on mount 210 , such that stepping down on actuation lever 235 forces wheels 230 downward, whereby to engage the floor and raise up body 40 (and hence table mount 25 ) off of the floor, with bar 245 slipping into recess 250 so as to lock wheels 230 in their “down” position. Note that in this “down” position, table mount 25 is supported on wheels 230 such that distraction frame 5 may be moved about on a floor.
- a release lever 255 also connected to linkage 240 ( FIG.
- linkage 240 moves bar 245 out of recess 250 , thereby allowing wheels 230 to retract upwards off of the floor, and hence allowing body 40 to settle onto the floor (i.e., with horizontal surface 50 of body 40 engaging the floor).
- retractable wheel assembly 205 may comprise a single-pedal mechanism of the sort well known in the art of material transport, with the single-pedal mechanism alternately moving wheels 230 between their upward and downward positions.
- Recess 53 also serves to receive the proximal ends of adjustable horizontal struts 30 as will hereinafter be discussed.
- Extension assembly 43 ( FIGS. 3, 6, 8, 13 and 14 ) comprises a mount 54 which is mounted to body 40 , and a pair of L-shaped extensions 55 which extend away from mount 54 (and which extend away from body 40 ).
- L-shaped extensions 55 are intended to extend on either side of base 15 of surgical table 10 .
- L-shaped extensions 55 essentially constitute “outriggers” which extend on either side of base 15 of surgical table 10 .
- Mount 54 (and hence L-shaped extensions 55 ) is secured to body 40 .
- L-shaped extensions 55 are adjustably secured to mount 54 with clamps 57 ( FIG. 3 ), i.e., so that L-shaped extensions 55 are laterally adjustably securable relative to mount 54 (and hence body 40 ).
- the laterally-adjustable L-shaped extensions 55 essentially constitute laterally-adjustable outriggers which extend on either side of base 15 of surgical table 10 .
- laterally adjustably securing L-shaped extensions 55 to mount 54 is advantageous, since it allows distraction frame 5 to accommodate different widths of bases 15 of surgical tables 10 , i.e., by allowing the outriggers (i.e., L-shaped extensions 55 ) to be laterally adjusted so as to straddle bases 15 of different widths.
- clamps 57 are shown in the figures as extending with a vertical orientation, clamps 57 could also be mounted to the side of mount 54 so that they extend with a horizontal orientation.
- a pair of L-shaped brackets 60 are slidably mounted to L-shaped extensions 55 and extend under base 15 of surgical table 10 so that the lower ends of L-shaped brackets 60 may be captured beneath table feet 62 ( FIGS. 13 and 14 ) of surgical table 10 (surgical tables 10 typically comprise rollers and retractable/extendable table feet, with the table feet being retracted so that the surgical tables are able to move on their rollers when the surgical tables are to be moved about a floor, and with the table feet being extended when the surgical tables are to be fixed in position on a floor).
- table feet 62 FIGS. 13 and 14
- L-shaped brackets 60 are slidable along extensions 55 so that L-shaped brackets 60 may be positioned beneath table feet 62 when the table feet are in their retracted position, and L-shaped brackets 60 each comprise a latch 63 for locking L-shaped brackets 60 in position along L-shaped extensions 55 ( FIGS. 13 and 14 ) when L-shaped brackets 60 are to be captured under the table feet when the table feet are extended to the floor.
- Positioning L-shaped brackets 60 under table feet 62 of surgical table 10 effectively holds distraction frame 5 in a fixed position relative to surgical table 10 by using the weight of surgical table 10 on L-shaped brackets 60 .
- distraction frame 5 does not need to be bolted to, or clamped to, surgical table 10 in order to effectively hold distraction frame 5 in a fixed position relative to surgical table 10 . This is a substantial advantage over prior art distraction frames.
- L-shaped brackets 60 can include L-shaped extensions 55 of different lengths or of different cross-sectional shapes and sizes.
- L-shaped brackets 60 may be similarly varied in construction, for instance, they may not necessarily be positioned under table feet 62 of base 15 of surgical table 10 , but may engage elsewhere under base 15 of surgical table 10 so as to achieve the same engagement between the floor, L-shaped extensions 55 and base 15 of surgical table 10 (i.e., with L-shaped extensions 55 being captured to the floor by base 15 of surgical table 10 ).
- L-shaped brackets 60 may be captured beneath another portion of base 15 of surgical table 10 .
- L-shaped brackets 60 may also have a height adjustment feature so that the vertical distance between (i) the portion of the L-shaped bracket which is mounted to the L-shaped extensions 55 , and (ii) the portion of the L-shaped bracket which mounts to the surgical table 10 , can be varied. This feature can accommodate uneven floors where the distance between each of the L-shaped extensions 55 and the floor may vary.
- a pair of adjustable supports 65 are mounted to L-shaped extensions 55 and also engage the floor upon which surgical table 10 sits.
- Adjustable supports 65 are preferably positioned at the ends of L-shaped extensions 55 which are opposite to body 40 , however, adjustable supports 65 may alternatively be located anywhere along the length of L-shaped extensions 55 , possibly with the overall length of L-shaped extensions 55 varying.
- Adjustable supports 65 preferably comprise a threaded engagement with L-shaped extensions 55 , and preferably further comprise a locking nut 66 ( FIG. 14 ) to lock adjustable supports 65 relative to L-shaped extensions 55 once adjustable supports 65 are in their desired positions.
- FIG. 14A which shows how a distraction force 400 applied to the leg of a patient creates a force moment 405 at table mount 25 which is transferred to the operating room floor as a force 410 via L-shaped extension 55 and adjustable supports 65 , and as a force 415 via L-shaped extensions 55 and L-shaped brackets 60 .
- This is highly advantageous since the force moments are transferred to the operating room floor and are not imposed on any mechanical connections between the distraction frame and the surgical table.
- the construction of the distraction frame of the present invention does not need to create a mechanical connection with the surgical table, the distraction frame of the present invention simply has its L-shaped brackets 60 clamped beneath table feet 62 of surgical table 10 .
- adjustable supports 65 are generally shown in the figures as having a threaded adjustment, adjustable supports 65 could also be actuated (e.g., raised and lowered, and locked in place) with a foot pedal mechanism (see, for example, the foot pedal mechanism 67 shown in FIG. 14B ).
- foot pedal mechanism 67 may comprise a mechanism generally similar to the retractable foot pegs 97 discussed below.
- Each of the adjustable horizontal struts 30 ( FIGS. 1-6, 8, 14, 15, 15A-15C, 16-21, 21A-21C and 22-27 ) comprises a proximal portion 75 and a distal portion 80 .
- Proximal portions 75 and distal portions 80 telescope relative to one another.
- a locking screw 85 ( FIG. 15 ) is provided to lock proximal portions 75 and distal portions 80 in position relative to one another.
- proximal portions 75 and distal portions 80 can be limited to discrete telescoping positions (e.g., to 3 discrete telescoping positions) or proximal portions 75 and distal portions 80 can be continuously telescopically variable relative to one another.
- rollers 87 are mounted to proximal portions 75 of adjustable horizontal struts 30 and roll against the inside surfaces of distal portions 80 . This provides low friction movement as proximal portions 75 telescope relative to distal portions 80 .
- Adjustable horizontal struts 30 are pivotally mounted to body 40 of table mount 25 . More particularly, proximal portions 75 of adjustable horizontal struts 30 are mounted to body 40 of table mount 25 with pivot mounts 90 ( FIG. 5 ). Pivot mounts 90 allow proximal portions 75 of adjustable horizontal struts 30 to be adjusted to the desired angular dispositions relative to body 40 of table mount 25 .
- Adjustable horizontal struts 30 are detachable from body 40 of table mount 25 with locking pins 92 ( FIG. 5 ). When locking pins 92 are raised, adjustable horizontal struts 30 can be detached from body 40 of table mount 25 , providing the ability to disassemble distraction frame 5 so as to allow, for example, easier transport of distraction frame 5 to another location. In an alternative construction, adjustable horizontal struts 30 may be permanently attached to body 40 of table mount 25 .
- Adjustable horizontal struts 30 comprise castors 95 which are disposed at the distal ends of distal portions 80 of adjustable horizontal struts 30 .
- Distal portions 80 of adjustable horizontal struts 30 also comprise retractable foot pegs 97 .
- retractable foot pegs 97 When retractable foot pegs 97 are in their retracted positions ( FIGS. 16 and 17 ), the distal ends of distal portions 80 of adjustable horizontal struts 30 are supported on castors 95 such that the distal ends of distal portions 80 of adjustable horizontal struts 30 may roll relative to the floor.
- retractable foot pegs 97 are in their extended positions ( FIGS. 20 and 21 )
- the distal ends of distal portions 80 of adjustable horizontal struts 30 are supported on retractable foot pegs 97 such that the distal ends of distal portions 80 of adjustable horizontal struts 30 may not roll relative to the floor.
- retractable foot pegs 97 may comprise a shaft 300 which is movably mounted to a housing assembly 305 (which is, in turn, mounted to distal portion 80 of adjustable horizontal strut 30 ).
- One end of shaft 300 comprises a foot 310 for selectively engaging the floor.
- the other end of shaft 300 comprises a pedal 315 for selective engagement by the foot of a user.
- a spring 317 biases shaft 300 upward, so that foot 310 is normally withdrawn from the floor.
- Shaft 300 also comprises a track 320
- housing assembly 305 also comprises a finger 325 which rides in track 320
- One end of finger 325 is pivotably mounted to housing assembly 305 while the other end of finger 325 comprises a projection 327 ( FIG. 21A ) which rides in track 320
- Track 320 and finger 325 are configured so that when a user steps on pedal 315 , driving foot 310 downward, finger 325 rides upward in a portion 328 ( FIG. 21 ) of track 320 until finger 325 hits a peak 330 ( FIG. 17 ) in track 320 .
- finger 325 settles into a recess 335 ( FIG.
- pedals 315 may be used to cycle retractable foot pegs 97 between their extended and retracted positions.
- shaft 300 comprises a gas shock assembly 345 ( FIG. 21A ) so that foot 310 can adjustably contact the floor. More particularly, in this form of the invention, gas shock assembly 345 comprises a rod 350 ( FIG. 21A ) which is secured to pedal 315 , and a cylinder 355 ( FIG. 21A ) which is movably mounted to rod 350 . Foot 310 is secured to cylinder 355 .
- the separation between pedal 315 and foot 310 can adjust to some extent as needed, e.g., when distraction frame 5 is applying a distraction force to the leg of the patient, distal portion 80 of adjustable horizontal strut 30 can tend to lift upward relative to the floor, and gas shock assembly 345 can act to keep foot 310 firmly engaging the floor, with a certain minimum amount of force (which can be varied by adjusting the gas shock force and overall travel).
- Adjustable horizontal struts 30 also comprise bearing rails 99 ( FIGS. 15, 15A-15C, 16, 20 and 22-27 ) and gear racks 100 disposed on distal portions 80 of adjustable horizontal struts 30 .
- Bearing rails 99 and gear racks 100 serve as a means to selectively lock adjustable vertical struts 35 at a specific location along distal portions 80 of adjustable horizontal struts 30 as will hereinafter be discussed.
- Each of the adjustable vertical struts 35 ( FIGS. 1, 2, 16, 20, 22-29, 29A-29C and 30-33 ) comprises a lower portion 105 ( FIG. 2 ), an intermediate portion 107 , and an upper portion 110 .
- Lower portions 105 comprise mounts 115 ( FIG. 22 ) for adjustably securing adjustable vertical struts 35 to bearing rails 99 and gear racks 100 disposed on distal portions 80 of adjustable horizontal struts 30 .
- Lock/release mechanisms 120 ( FIG. 24 ) are provided for locking/releasing adjustable vertical struts 35 at particular dispositions along bearing rails 99 and gear racks 100 disposed on distal portions 80 of adjustable horizontal struts 30 .
- lock/release mechanisms 120 are normally “locked” when in their “default” condition, such that mounts 115 and gear racks 100 prevent unintentional travel of adjustable vertical struts 35 along adjustable horizontal struts 30 , e.g., such as when performing a hip distraction.
- mounts 115 comprise bearings 121 ( FIG. 22 ) which roll along bearing rails 99 , allowing adjustable vertical struts 35 to travel along the length of distal portions 80 of adjustable horizontal struts 30 .
- This is for the purpose of allowing the user to adjust the positions of adjustable vertical struts 35 on distal portions 80 of adjustable horizontal struts 30 in order to provide different configurations for the distraction frame during a hip arthroscopy procedure (e.g., to flex or extend the leg of a patient).
- Lock/release mechanisms 120 are used to lock (or release) adjustable vertical struts 35 to (or from) adjustable horizontal struts 30 . More particularly, lock/release mechanisms 120 each comprise a control 122 ( FIGS. 24 and 25 ) which is used to engage/disengage a gear lock 123 (which is housed in mount 115 ) to/from gear rack 100 .
- Control 122 may be disposed within a handle 124 .
- a cable 125 FIG. 25
- a spring returns gear lock 123 back to its engaged state when control 122 (e.g., a trigger) is released, i.e., when lock/release mechanism 120 is in its “default” condition.
- Upper portions 110 , intermediate portions 107 and lower portions 105 telescope relative to one another.
- Locking screws 127 FIGS. 28 and 29 ) are provided to lock upper portions 110 relative to intermediate portions 107 .
- upper portions 110 and intermediate portions 107 can be limited to discrete telescoping positions (e.g., to 5 discrete telescoping positions) or upper portions 110 and intermediate portions 107 can be continuously telescopically variable relative to one another.
- Handles 130 may be provided for lifting or lowering upper portions 110 and intermediate portions 107 of adjustable vertical struts 35 relative to lower portions 105 of adjustable vertical struts 35 .
- rollers 128 are mounted to intermediate portions 107 and roll along the inner surfaces of lower portions 105 . This provides low friction movement as intermediate portions 107 telescope relative to lower portions 105 .
- gas shocks 132 may be provided within the bodies of lower portions 105 of adjustable vertical struts 35 to help carry the loads of upper portions 110 and intermediate portions 107 of adjustable vertical struts 35 (and any loads carried thereby, e.g., the leg of a patient).
- gas shocks 132 are housed within inner lumens of vertical struts 35 , with one end of gas shocks 132 being mounted to mount 115 and the other end of gas shocks 132 being mounted to intermediate portions 107 .
- gas shocks 132 may be used across all three portions of adjustable vertical struts 35 (i.e., lower portions 105 , intermediate portions 107 and upper portions 110 ), or between a pair of portions 105 / 107 / 110 , preferably between lower portions 105 and intermediate portions 107 , but gas shocks 132 may also be used between upper portions 110 and intermediate portions 107 .
- gas shocks 132 are provided to assist in adjusting the dispositions of upper portions 110 and intermediate portions 107 of adjustable vertical struts 35
- gas shocks 132 are configured to apply an upward force on intermediate portions 107 of adjustable vertical struts 35 (and hence on upper portions 110 , which are connected to intermediate portions 107 )
- gas shocks 132 include lock mechanisms 133 ( FIGS. 26 and 27 ) for locking gas shocks 132 in a particular disposition.
- a button 134 FIGS.
- buttons 134 are depressed to disengage lock mechanism 133 such that gas shocks 132 are free to apply an upward force to upper portions 110 and intermediate portions 107 of adjustable vertical struts 35 (and any loads carried thereby) relative to lower portion 105 of adjustable vertical struts 35 .
- the depression of button 134 pushes a rod 134 A ( FIGS. 26 and 27 ), which then pivots a wheel 134 B, which then pulls cable 134 C, which then lifts one end of a finger 135 , whereby to force the other end of finger 135 to depress lock mechanism 133 .
- a spring biases the foregoing elements in the opposite direction so as to release lock mechanism 133 .
- alternative constructions may include springs or counter-weight systems to balance the loads carried by adjustable vertical struts 35 .
- Hinge joints 137 are disposed at the upper ends of upper portions 110 of adjustable vertical struts 35 .
- Distraction mechanisms 140 are mounted at the top ends of upper portions 110 of adjustable vertical struts 35 via hinge joints 137 .
- Universal joints 145 are disposed at the ends of distraction mechanisms 140 .
- Mounts 150 are configured to releasably engage surgical boots 20 , such that surgical boots 20 can be releasably secured to distraction mechanisms 140 (and hence to distraction frame 5 ).
- Levers 155 disposed at the opposing ends of distraction mechanisms 140 , are used by the user to operate distraction mechanisms 140 .
- Distraction mechanisms 140 are of the sort well known in the art and generally comprise a mechanism which provides a significant mechanical advantage for the user. With this mechanical advantage, the user can apply a significant amount of distraction force to the leg of the patient.
- distraction mechanisms 140 comprise a force gauge 157 ( FIGS. 30-33 ) which indicates the actual force being applied by distraction mechanisms 140 to the leg of a patient. The user can, for example, minimize potential injury to the patient if the force does not exceed a certain threshold.
- Force gauge 157 may be mechanical (e.g., a simple “fish scale” device with lines and numbers) or electronic (e.g., with a digital readout).
- the various components of distraction frame 5 are constructed so that distraction frame 5 can be “collapsed” into a compacted form, e.g., with adjustable horizontal struts 30 being telescoped into a reduced length and with adjustable vertical struts 35 being telescoped into a reduced length; and with adjustable vertical struts 35 being disposed parallel to adjustable horizontal struts 30 ; and with distraction mechanisms 140 being disposed parallel to adjustable vertical struts 35 and adjustable horizontal struts 30 ; and with L-shaped extensions 55 being inverted so that L-shaped brackets 60 and adjustable supports 65 face upward and with L-shaped extensions 55 being reversed relative to body 40 of table mount 25 so that L-shaped extensions 55 are set back over adjustable horizontal struts 30 .
- distraction frame 5 can be transported to another operating room or other location in the hospital (e.g., a storage location). Effectively, in this configuration, distraction frame 5 does not require a separate piece of equipment for mobility (e.g., a tote, a dolly, etc.). This provides significant convenience for the hospital staff.
- Distraction frame 5 is preferably used as follows.
- distraction frame 5 is assembled so that adjustable horizontal struts 30 are mounted to table mount 25 , adjustable vertical struts 35 are mounted to adjustable horizontal struts 30 , and distraction mechanisms 140 are mounted to upper portions 110 of adjustable vertical struts 35 (if these components are not already mounted to one another).
- L-shaped extensions 55 are set so that L-shaped brackets 60 and adjustable supports 65 face downward, and L-shaped extensions 55 are attached to body 40 of table mount 25 so that L-shaped extensions 55 extend away from adjustable horizontal struts 30 (if these components are not already set in this position).
- distraction frame 5 is wheeled up to surgical table 10 on wheels 230 of retractable wheel assembly 205 and castors 95 of adjustable horizontal struts 30 , and distraction frame 5 is assembled to surgical table 10 by mounting table mount 25 to base 15 of surgical table 10 , e.g., by setting L-shaped extensions 55 on both sides of base 15 of surgical table 10 , positioning L-shaped brackets 60 beneath table feet 62 of surgical table 10 , retracting wheels 230 of retractable wheel assembly 205 so that horizontal surface 50 of body 40 seats on the floor, and then lowering feet 62 of surgical table 10 onto L-shaped brackets 60 .
- Adjustable supports 65 are also adjusted as necessary to make secure contact to the floor.
- distraction frame 5 is approximately configured for the size of the patient, the size of the surgeon, and the procedure to be conducted. This is done by setting the angles of adjustable horizontal struts 30 relative to table mount 25 (and hence relative to surgical table 10 ), setting the lengths of adjustable horizontal struts 30 , setting the dispositions of adjustable vertical struts 35 on adjustable horizontal struts 30 , and setting the heights of adjustable vertical struts 35 .
- Surgical boots 20 are secured to distraction mechanisms 140 disposed at the top ends of upper portions 110 of adjustable vertical struts 35 . Further adjustments may be made to distraction frame 5 as necessary.
- Distraction may occur with the surgical table set in a horizontal position or in an inclined position (e.g., with the patient in the so-called Trendelenburg position).
- a horizontal position e.g., with the patient in the so-called Trendelenburg position.
- distraction will now be discussed in the context of the patient having their leg distracted while in the Trendelenberg position.
- the patient is tilted on the surgical table to the Trendelenburg position. This is accomplished with the surgical table controls. Preferentially the amount of Trendelenburg angle is 15 degrees or less.
- distraction frame 5 may be adjusted again as needed.
- the height of adjustable vertical struts 35 might be increased to maintain the patient in a planar position (relative to the table top) or with a small amount of hip flexion; horizontal struts 30 may then be adjusted so as to minimize distraction forces applied to the hip.
- lock/release mechanism 120 of mount 115 is able to be maintained in an unlocked position. This allows for the change in angle relative to distraction frame 5 without putting undue stresses on the patient as the leg length changes relative to the horizontal plane of adjustable horizontal strut 30 .
- distraction frame 5 is more precisely configured to begin the procedure to be conducted. This is done by more precisely setting the angles of adjustable horizontal struts 30 relative to table mount 25 (and hence relative to surgical table 10 ), more precisely setting the dispositions of adjustable vertical struts 35 on adjustable horizontal struts 30 , and more precisely setting the heights of adjustable vertical struts 35 , more precisely setting the length and angle of the distraction mechanisms 140 , and more precisely setting the angle of surgical boots 20 .
- the patient's hip may then be distracted by the surgical team by unlocking lock/release mechanism 120 of mount 115 and pulling distally on adjustable vertical struts 35 , e.g., via handle 124 . From this starting position, at least 8 inches of travel along the horizontal struts 30 is provided for the surgical team to apply this pulling force to the patient. Then distraction mechanisms 140 (disposed at the top ends of upper portions 110 of adjustable vertical struts 35 ) are adjusted as needed so as to apply the desired distraction force to the distal end of the patient's leg. From the starting position, at least 4 inches of additional travel is provided within distraction mechanism 140 to apply force to the patient's leg. Any combination of these applications of traction is envisioned, as needed for the patient's treatment.
- a surgical procedure may then be conducted on the distracted hip.
- distraction frame 5 of the present invention provides the ability to attain more C-arm positions than prior art distraction frames. This is due to the fact that distraction frame 5 mounts to base 15 of surgical table 10 and not to the end of the surgical table. Therefore, the space immediately under table extender 23 and above table mount 25 and adjustable horizontal struts 30 is open and allows the C-arm X-ray machine to be manipulated with a high degree of freedom.
- distraction frame 5 of the present invention has 8 degrees of freedom: (1) gross traction extension/retraction (moving adjustable vertical struts 35 away from/toward the patient); (2) adduction/abduction of adjustable horizontal struts 30 pivoting about body 40 ; (3) adjustable vertical struts 35 raising and lowering; (4) distraction mechanisms 140 (fine traction) pivoting on adjustable vertical struts 35 ; (5) distraction mechanisms 140 (fine traction) retracting/advancing; and (6), (7) and (8) surgical boots 20 rotating and pivoting about universal joints 145 .
- the 8 degrees of freedom provided by distraction frame 5 are superior to the 3-5 degrees of freedom typically provided by the prior art, thereby providing the surgeon with the ability to position the patient's leg in a greater number of positions and orientations. This allows the surgeon to access anatomy that they could not previously be accessed with the distraction systems of the prior art.
- the distraction frame of the present invention also allows for more deep flexion of the patient's hip due to the increased degrees of freedom provided by the distraction frame and due to the disassociation of the height of the distraction frame (where the patient's foot connects to the distraction frame) relative to the top of the surgical table. Because the patient's foot can be raised (by adjustment of the vertical struts) independently of the patient's horizontal position, additional flexion can be achieved by the distraction frame of the present invention.
- distraction frame 5 is able to accommodate a wide range of patient heights, i.e., from approximately 4′10′′ to approximately 6′10′′. This ability to accommodate a wide range of patient heights is due to the more numerous degrees of freedom combined with the adjustable nature of various components of distraction frame 5 , e.g., the adjustability of adjustable horizontal struts 30 .
- adjustable vertical struts 35 can be positioned away from surgical table 10 ; this provides more space for the surgical staff to maneuver at the end of the table during surgical preparation, including while a patient is being transferred onto the surgical table.
- the surgical table may also be manipulated to effect hip distraction. More particularly, and looking now at FIG. 36 , the bed 160 of surgical table 10 can typically be moved up/down, moved cephalad/caudal, tilted head-to-toe, and tilted side-to-side. If a patient is positioned on bed 160 of surgical table 10 and the patient's feet are attached to distraction frame 5 , then movement of bed 160 of surgical table 10 in a cephalad direction will have the same effect as applying tension to the leg by means of turning levers 155 of distraction mechanisms 140 so as to move the foot in a caudal direction.
- a patient can be in either a lateral decubitus position or a supine position on surgical table 10 .
- a lateral decubitus position the patient lays on their side on the surgical table with the non-operative leg supported by the table and the operative leg supported by distraction frame 5 .
- the operative leg is supported by distraction frame 5 and the non-operative leg would rest on surgical table 10 and table extender 23 .
- table extender 23 typically stops above the knee of the patient, so the non-operative leg has limited support.
- one of adjustable vertical struts 35 may replace its hinge joint 137 , distraction mechanism 140 , universal joint 145 , mount 150 , force gauge 157 and lever 155 with a leg board 165 ( FIG. 37 ) which is mounted to one of the adjustable vertical struts. Since the non-operative leg sees no force during distraction and is typically not manipulated, the non-operative leg does not need to be secured to distraction frame 5 but can simply be supported by leg board 165 .
- distraction frame 5 may be used for orthopedic procedures other than hip arthroscopy, e.g., distraction frame 5 may be used for hip trauma, total hip replacement, etc.
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Abstract
Description
- This patent application claims benefit of:
- (i) pending prior U.S. Provisional Patent Application Ser. No. 62/455,238, filed Feb. 6, 2017 by Stryker Corp. and Conrad Smith et al. for METHOD AND APPARATUS FOR EFFECTING HIP DISTRACTION (Attorney's Docket No. FIAN-117 PROV); and
- (ii) pending prior U.S. Provisional Patent Application Ser. No. 62/546,686, filed Aug. 17, 2017 by Stryker Corp. and Conrad Smith et al. for DISTRACTION FRAME FOR EFFECTING HIP DISTRACTION (Attorney's Docket No. FIAN-123 PROV).
- The two (2) above-identified patent applications are hereby incorporated herein by reference.
- This invention relates to medical apparatus in general, and more particularly to medical apparatus for effecting hip distraction.
- When performing surgical procedures on the hip joint, it is common to distract the hip joint prior to the surgery in order to provide additional room within the hip joint during the surgery and in order to better present selected anatomy to the surgeon. This hip distraction is commonly achieved by applying a distraction force to the distal end of the leg of the patient. Currently, a surgical boot is placed on the foot and lower leg of the patient, the surgical boot is connected to a distraction frame, and then the distraction frame is used to apply a distraction force to the surgical boot, whereby to apply a distraction force to the leg of the patient, whereby to distract and position the hip joint.
- The present invention is intended to provide a new and improved distraction frame for applying a distraction force to the leg of the patient so as to effect hip distraction and to allow for leg positioning.
- The present invention provides a new and improved distraction frame for applying a distraction force to the leg of the patient so as to effect hip distraction and to allow for leg positioning.
- In one form of the invention, there is provided a distraction frame for use with a surgical table, wherein the surgical table comprises a base for positioning on a floor, the distraction frame comprising:
- a table mount for fixation to the base of the surgical table;
- at least one horizontal strut mounted to the table mount;
- at least one vertical strut mounted to the at least one horizontal strut; and
- at least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient;
- wherein the table mount is configured to transfer to the floor a force moment imposed on the table mount when the at least one distraction mechanism applies a distraction force to a limb of a patient.
- In another form of the invention, there is provided a method for distracting a limb of a patient, the method comprising:
- providing a distraction frame for use with a surgical table, wherein the surgical table comprises a base for positioning on a floor, the distraction frame comprising:
-
- a table mount for fixation to the base of the surgical table;
- at least one horizontal strut mounted to the table mount;
- at least one vertical strut mounted to the at least one horizontal strut; and
- at least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient;
- wherein the table mount is configured to transfer to the floor a force moment imposed on the table mount when the at least one distraction mechanism applies a distraction force to a limb of a patient;
- positioning the patient on the surgical table;
- connecting the limb of the patient to the at least one distraction mechanism; and
- applying a distraction force to the limb of the patient using the at least one distraction mechanism.
- In another form of the invention, there is provided a distraction frame comprising:
- a table mount for fixation to a surgical table;
- at least one horizontal strut mounted to the table mount;
- at least one vertical strut mounted to the at least one horizontal strut; and
- at least one distraction mechanism mounted to the at least one vertical strut, wherein the at least one distraction mechanism is configured for connection to a limb of a patient and for applying a distraction force to the limb of the patient;
- wherein the table mount comprises a surface for selectively contacting the floor, and further wherein the table mount comprises at least one wheel for selectively supporting the surface of the table mount above the floor; and
- wherein the at least one horizontal strut comprises at least one caster for selectively rollably supporting the at least one horizontal strut on the floor, and further wherein the table mount comprises at least one foot peg for selectively supporting the at least one caster above the floor;
- such that (i) the distraction frame can be moved to the surgical table supported by the at least one wheel and the at least one caster, and (ii) the distraction frame can be fixed adjacent to the surgical table supported by the surface of the table mount and the at least one foot peg.
- These and other objects and features of the present invention will be more fully disclosed or rendered obvious by the following detailed description of the preferred embodiments of the invention, which is to be considered together with the accompanying drawings wherein like numbers refer to like parts, and further wherein:
-
FIGS. 1 and 2 are schematic views showing a novel distraction frame formed in accordance with the present invention; -
FIGS. 3-14 are schematic views showing details of the table mount of the novel distraction frame shown inFIGS. 1 and 2 ; -
FIG. 14A is a schematic view showing how a distraction force applied to the leg of a patient creates a force moment at the table mount which is transferred to the operating room floor; -
FIG. 14B is a schematic view showing a foot pedal mechanism which may be used in place of the adjustable supports of the table mount shown inFIGS. 3-14 ; -
FIGS. 15, 15A-15C, 16-21, 21A-21C and 22-27 are schematic views showing details of the adjustable horizontal struts, the adjustable vertical struts, and elements attached to these struts, of the novel distraction frame shown inFIGS. 1 and 2 ; -
FIGS. 28, 29, 29A-29C and 30-33 are schematic views showing further details of the adjustable vertical struts (and elements attached to these struts) of the novel distraction frame shown inFIGS. 1 and 2 ; -
FIGS. 34 and 35 are schematic views showing how the novel distraction frame ofFIGS. 1 and 2 can be positioned in transport mode for movement about a facility; -
FIG. 36 is a schematic view showing how table tilt can be used to influence distraction after a patient's leg has been secured to a distraction frame; and -
FIG. 37 is a schematic view showing another novel distraction frame formed in accordance with the present invention, wherein the distraction frame comprises a leg rest for supporting the non-operative leg of a patient. - The present invention provides a new and improved distraction frame for applying a distraction force to the leg of a patient so as to effect hip distraction.
- More particularly, and looking first at
FIGS. 1 and 2 , there is shown anovel distraction frame 5 formed in accordance with the present invention. Also shown inFIG. 1 is (i) a surgical table 10 for supporting a patient during surgery, wherein surgical table 10 comprises abase 15, and (ii) a pair ofsurgical boots 20 for disposition on the feet and lower legs of the patient. Surgical table 10 may be of the sort well known in the art.Surgical boots 20 may be the novel surgical boots shown in the aforementionedFIGS. 1 and 2 and described and illustrated in detail in co-pending U.S. patent application Ser. Nos. 62/455,154 (Attorney's Docket No. FIAN-118 PROV), 62/546,629 (Attorney's Docket No. FIAN-124 PROV), and Ser. No. 15/889,998 (Attorney's Docket No. FIAN-118124), and/orsurgical boots 20 may be conventional surgical boots of the sort well known in the art. - If desired, surgical table 10 may also comprise a
novel table extender 23 which is configured to be mounted to the foot of surgical table 10, whereby to provide additional support for the patient during a surgical procedure.Novel table extender 23 is preferably substantially radiolucent, so that X-ray imaging can be conducted on anatomy supported bynovel table extender 23.Novel table extender 23 is described and illustrated in detail in co-pending U.S. patent application Ser. Nos. 62/455,143 (Attorney's Docket No. FIAN-122 PROV), 62/546,600 (Attorney's Docket No. FIAN-125 PROV) and Ser. No. 15/890,047 (Attorney's Docket No. FIAN-122125). If desired,table extender 23 may comprise adistraction post 24, which is the traditional means for facilitating hip distraction (e.g., by providing counter-traction to stabilize the patient on the surgical table and by levering the upper end of the leg of the patient against the distraction post so as to dislocate the femoral head from the acetabular cup). Such distraction posts are well known in the art of hip distraction. -
Distraction frame 5 generally comprises atable mount 25, a pair of adjustablehorizontal struts 30 and a pair of adjustablevertical struts 35. - Table mount 25 (
FIGS. 1-14 ) generally comprises abody 40 and anextension assembly 43. -
Body 40 generally comprises avertical surface 45, ahorizontal surface 50 and arecess 53. -
Vertical surface 45 ofbody 40 is intended to sit adjacent to, but slightly spaced from,base 15 of surgical table 10. Alternatively,vertical surface 45 ofbody 40 may be in contact withbase 15 of surgical table 10. Or, alternatively,vertical surface 45 ofbody 40 may be set a distance offbase 15 of surgical table 10. Note that the ability to spacevertical surface 45 ofbody 40 frombase 15 of surgical table 10 can be advantageous, since it allowsdistraction frame 5 to work with a wide range of surgical tables. -
Horizontal surface 50 ofbody 40 is intended to engage the operating room floor during hip distraction. -
Recess 53 is intended to receive aretractable wheel assembly 205, whereinretractable wheel assembly 205 is configured for selectively (i) projecting out ofrecess 53 so as to engage the floor andmovably support body 40 of table mount 25 above the floor, such thatdistraction frame 5 may be moved about a facility (for example, to movedistraction frame 5 to another operating room or to a storage area), and (ii) retracting intorecess 53 so as to disengage from the operating room floor and lowerhorizontal surface 50 ofbody 40 onto the operating room floor so as to prevent movement of distraction frame 5 (e.g., during a surgery). - In one preferred form of the invention, and looking now at
FIGS. 1-12 ,retractable wheel assembly 205 generally comprises amount 210 for mounting tobody 40 of table mount 25 (FIGS. 6 and 8 ), and a base 215 movably mounted to mount 210. Aspring 220 spring biases base 215 upward into the interior ofmount 210. Anaxle 225, supportingwheels 230, passes throughbase 215. As a result of this construction, when base 215 moves upward and downward relative to mount 210,wheels 230 move upward and downward relative tobody 40 oftable mount 25. - An
actuation lever 235, together with alinkage 240 and abar 245, cooperate with a recess 250 (FIG. 11 ) onmount 210, such that stepping down onactuation lever 235forces wheels 230 downward, whereby to engage the floor and raise up body 40 (and hence table mount 25) off of the floor, withbar 245 slipping intorecess 250 so as to lockwheels 230 in their “down” position. Note that in this “down” position, table mount 25 is supported onwheels 230 such thatdistraction frame 5 may be moved about on a floor. Arelease lever 255, also connected to linkage 240 (FIG. 10 ), is provided for retractingwheels 230, i.e., by stepping down onrelease lever 255,linkage 240 moves bar 245 out ofrecess 250, thereby allowingwheels 230 to retract upwards off of the floor, and hence allowingbody 40 to settle onto the floor (i.e., withhorizontal surface 50 ofbody 40 engaging the floor). - Note that when
wheels 230 are in their “retracted” position (FIG. 6 ), the arm 257 (FIG. 12 ) ofactuation lever 235 andlinkage 240 project “off-center” towards bar 245 (FIG. 7 ), and whenwheels 230 are in their “down” position, withbar 245 slipped intorecess 250,arm 257 ofactuation lever 235 andlinkage 240 project “off-center” away from bar 245 (FIG. 10 ). Note also that whenrelease lever 255 is to be used for retractingwheels 230,release lever 255 essentially moveslinkage 240 “over center”, from its “off-center” position away from bar 245 (FIG. 10 ) towards its “off-center” position towards bar 245 (FIG. 7 ). Oncerelease lever 255 moveslinkage 240 “over center”, the weight of the structure(s) being supported by wheels 230 (e.g., the weight of distraction frame 5) provides the major force for retractingwheels 230 intorecess 53. - It will be appreciated that, in view of the foregoing construction, (i) stepping down on
actuation lever 235locks wheels 230 in their “down” position, so that table mount 25 is movably supported onwheels 230, and (ii) stepping down onrelease lever 255 retractswheels 230 intorecess 53 ofbody 40, whereby to allowhorizontal surface 50 ofbody 40 to seat on the operating room floor. - In an alternative embodiment,
retractable wheel assembly 205 may comprise a single-pedal mechanism of the sort well known in the art of material transport, with the single-pedal mechanism alternately movingwheels 230 between their upward and downward positions. -
Recess 53 also serves to receive the proximal ends of adjustablehorizontal struts 30 as will hereinafter be discussed. - Extension assembly 43 (
FIGS. 3, 6, 8, 13 and 14 ) comprises amount 54 which is mounted tobody 40, and a pair of L-shapedextensions 55 which extend away from mount 54 (and which extend away from body 40). L-shapedextensions 55 are intended to extend on either side ofbase 15 of surgical table 10. Thus, L-shapedextensions 55 essentially constitute “outriggers” which extend on either side ofbase 15 of surgical table 10. Mount 54 (and hence L-shaped extensions 55) is secured tobody 40. L-shapedextensions 55 are adjustably secured to mount 54 with clamps 57 (FIG. 3 ), i.e., so that L-shapedextensions 55 are laterally adjustably securable relative to mount 54 (and hence body 40). Thus, the laterally-adjustable L-shapedextensions 55 essentially constitute laterally-adjustable outriggers which extend on either side ofbase 15 of surgical table 10. Note that laterally adjustably securing L-shapedextensions 55 to mount 54 is advantageous, since it allowsdistraction frame 5 to accommodate different widths ofbases 15 of surgical tables 10, i.e., by allowing the outriggers (i.e., L-shaped extensions 55) to be laterally adjusted so as to straddlebases 15 of different widths. Althoughclamps 57 are shown in the figures as extending with a vertical orientation, clamps 57 could also be mounted to the side ofmount 54 so that they extend with a horizontal orientation. - A pair of L-shaped
brackets 60 are slidably mounted to L-shapedextensions 55 and extend underbase 15 of surgical table 10 so that the lower ends of L-shapedbrackets 60 may be captured beneath table feet 62 (FIGS. 13 and 14 ) of surgical table 10 (surgical tables 10 typically comprise rollers and retractable/extendable table feet, with the table feet being retracted so that the surgical tables are able to move on their rollers when the surgical tables are to be moved about a floor, and with the table feet being extended when the surgical tables are to be fixed in position on a floor). More particularly, L-shapedbrackets 60 are slidable alongextensions 55 so that L-shapedbrackets 60 may be positioned beneathtable feet 62 when the table feet are in their retracted position, and L-shapedbrackets 60 each comprise alatch 63 for locking L-shapedbrackets 60 in position along L-shaped extensions 55 (FIGS. 13 and 14 ) when L-shapedbrackets 60 are to be captured under the table feet when the table feet are extended to the floor. Positioning L-shapedbrackets 60 undertable feet 62 of surgical table 10 effectively holdsdistraction frame 5 in a fixed position relative to surgical table 10 by using the weight of surgical table 10 on L-shapedbrackets 60. Thus, with the present invention,distraction frame 5 does not need to be bolted to, or clamped to, surgical table 10 in order to effectively holddistraction frame 5 in a fixed position relative to surgical table 10. This is a substantial advantage over prior art distraction frames. - Alternative constructions can include L-shaped
extensions 55 of different lengths or of different cross-sectional shapes and sizes. L-shapedbrackets 60 may be similarly varied in construction, for instance, they may not necessarily be positioned undertable feet 62 ofbase 15 of surgical table 10, but may engage elsewhere underbase 15 of surgical table 10 so as to achieve the same engagement between the floor, L-shapedextensions 55 andbase 15 of surgical table 10 (i.e., with L-shapedextensions 55 being captured to the floor bybase 15 of surgical table 10). By way of example but not limitation, L-shapedbrackets 60 may be captured beneath another portion ofbase 15 of surgical table 10. Note that L-shapedbrackets 60 may also have a height adjustment feature so that the vertical distance between (i) the portion of the L-shaped bracket which is mounted to the L-shapedextensions 55, and (ii) the portion of the L-shaped bracket which mounts to the surgical table 10, can be varied. This feature can accommodate uneven floors where the distance between each of the L-shapedextensions 55 and the floor may vary. - A pair of adjustable supports 65 (
FIG. 14 ) are mounted to L-shapedextensions 55 and also engage the floor upon which surgical table 10 sits.Adjustable supports 65 are preferably positioned at the ends of L-shapedextensions 55 which are opposite tobody 40, however,adjustable supports 65 may alternatively be located anywhere along the length of L-shapedextensions 55, possibly with the overall length of L-shapedextensions 55 varying.Adjustable supports 65 preferably comprise a threaded engagement with L-shapedextensions 55, and preferably further comprise a locking nut 66 (FIG. 14 ) to lockadjustable supports 65 relative to L-shapedextensions 55 onceadjustable supports 65 are in their desired positions. - It will be appreciated that, on account of the foregoing construction, when table mount 25 of
distraction frame 5 is mounted to base 15 of surgical table 10 (e.g., by way of L-shapedbrackets 60 being captured undertable feet 62 ofbase 15 of surgical table 10, and byadjustable supports 65 being positioned securely against the floor), anddistraction frame 5 is thereafter used to apply a distraction force to the leg of a patient (e.g., via adjustable horizontal struts 30, adjustablevertical struts 35, etc.), any force moment produced attable mount 25 will be to transferred to the operating room floor via L-shapedextensions 55 andadjustable supports 65, and via L-shapedextensions 55 and L-shapedbrackets 60. See, for example,FIG. 14A , which shows how adistraction force 400 applied to the leg of a patient creates aforce moment 405 attable mount 25 which is transferred to the operating room floor as aforce 410 via L-shapedextension 55 andadjustable supports 65, and as aforce 415 via L-shapedextensions 55 and L-shapedbrackets 60. This is highly advantageous since the force moments are transferred to the operating room floor and are not imposed on any mechanical connections between the distraction frame and the surgical table. Indeed, as noted above, the construction of the distraction frame of the present invention does not need to create a mechanical connection with the surgical table, the distraction frame of the present invention simply has its L-shapedbrackets 60 clamped beneathtable feet 62 of surgical table 10. - Note that modifications to the materials of construction, or to the configuration of the design elements (e.g., L-shaped
brackets 60,adjustable supports 65, etc.) may be made to alter the stiffness and performance ofdistraction frame 5 while still maintaining the same overall design to transfer the patient distraction forces to the floor of the operating room. For example, althoughadjustable supports 65 are generally shown in the figures as having a threaded adjustment,adjustable supports 65 could also be actuated (e.g., raised and lowered, and locked in place) with a foot pedal mechanism (see, for example, thefoot pedal mechanism 67 shown inFIG. 14B ). In this alternative construction,foot pedal mechanism 67 may comprise a mechanism generally similar to the retractable foot pegs 97 discussed below. - Each of the adjustable horizontal struts 30 (
FIGS. 1-6, 8, 14, 15, 15A-15C, 16-21, 21A-21C and 22-27 ) comprises aproximal portion 75 and adistal portion 80.Proximal portions 75 anddistal portions 80 telescope relative to one another. A locking screw 85 (FIG. 15 ) is provided to lockproximal portions 75 anddistal portions 80 in position relative to one another. If desired,proximal portions 75 anddistal portions 80 can be limited to discrete telescoping positions (e.g., to 3 discrete telescoping positions) orproximal portions 75 anddistal portions 80 can be continuously telescopically variable relative to one another. In one preferred form of the invention, and looking now atFIGS. 15A-15C ,rollers 87 are mounted toproximal portions 75 of adjustablehorizontal struts 30 and roll against the inside surfaces ofdistal portions 80. This provides low friction movement asproximal portions 75 telescope relative todistal portions 80. - Adjustable horizontal struts 30 are pivotally mounted to
body 40 oftable mount 25. More particularly,proximal portions 75 of adjustablehorizontal struts 30 are mounted tobody 40 of table mount 25 with pivot mounts 90 (FIG. 5 ). Pivot mounts 90 allowproximal portions 75 of adjustablehorizontal struts 30 to be adjusted to the desired angular dispositions relative tobody 40 oftable mount 25. - Adjustable horizontal struts 30 are detachable from
body 40 of table mount 25 with locking pins 92 (FIG. 5 ). When locking pins 92 are raised, adjustablehorizontal struts 30 can be detached frombody 40 oftable mount 25, providing the ability to disassembledistraction frame 5 so as to allow, for example, easier transport ofdistraction frame 5 to another location. In an alternative construction, adjustablehorizontal struts 30 may be permanently attached tobody 40 oftable mount 25. - Adjustable horizontal struts 30 comprise
castors 95 which are disposed at the distal ends ofdistal portions 80 of adjustable horizontal struts 30.Distal portions 80 of adjustablehorizontal struts 30 also comprise retractable foot pegs 97. When retractable foot pegs 97 are in their retracted positions (FIGS. 16 and 17 ), the distal ends ofdistal portions 80 of adjustablehorizontal struts 30 are supported oncastors 95 such that the distal ends ofdistal portions 80 of adjustablehorizontal struts 30 may roll relative to the floor. When retractable foot pegs 97 are in their extended positions (FIGS. 20 and 21 ), the distal ends ofdistal portions 80 of adjustablehorizontal struts 30 are supported on retractable foot pegs 97 such that the distal ends ofdistal portions 80 of adjustablehorizontal struts 30 may not roll relative to the floor. - In one preferred form of the invention, and looking now at
FIGS. 16-21 and 21A-21C , retractable foot pegs 97 may comprise ashaft 300 which is movably mounted to a housing assembly 305 (which is, in turn, mounted todistal portion 80 of adjustable horizontal strut 30). One end ofshaft 300 comprises afoot 310 for selectively engaging the floor. The other end ofshaft 300 comprises apedal 315 for selective engagement by the foot of a user. A spring 317 (FIG. 21B )biases shaft 300 upward, so thatfoot 310 is normally withdrawn from the floor. -
Shaft 300 also comprises atrack 320, andhousing assembly 305 also comprises afinger 325 which rides intrack 320. One end offinger 325 is pivotably mounted tohousing assembly 305 while the other end offinger 325 comprises a projection 327 (FIG. 21A ) which rides intrack 320.Track 320 andfinger 325 are configured so that when a user steps onpedal 315, drivingfoot 310 downward,finger 325 rides upward in a portion 328 (FIG. 21 ) oftrack 320 untilfinger 325 hits a peak 330 (FIG. 17 ) intrack 320. When the user thereafter steps off ofpedal 315,finger 325 settles into a recess 335 (FIG. 17 ) formed intrack 320, whereby to lockfoot 310 in its extended position (FIGS. 19 and 20 ), withdistal portion 80 of adjustablehorizontal strut 30 supported on retractable foot peg 97 (i.e., withcastors 95 not in contact with the floor). When the user thereafter steps onpedal 315 again,finger 325 rides out ofrecess 335 and down a portion 338 (FIG. 17 ) oftrack 320 untilfinger 325 settles into a well 340 (FIG. 17 ), whereby to lockfoot 310 in its retracted position (FIGS. 16 and 17 ), withdistal portion 80 of adjustablehorizontal strut 30 supported oncastor 95. In this way,pedals 315 may be used to cycle retractable foot pegs 97 between their extended and retracted positions. - In one preferred form of the invention,
shaft 300 comprises a gas shock assembly 345 (FIG. 21A ) so thatfoot 310 can adjustably contact the floor. More particularly, in this form of the invention,gas shock assembly 345 comprises a rod 350 (FIG. 21A ) which is secured to pedal 315, and a cylinder 355 (FIG. 21A ) which is movably mounted torod 350.Foot 310 is secured tocylinder 355. As a result of this construction, the separation betweenpedal 315 andfoot 310 can adjust to some extent as needed, e.g., whendistraction frame 5 is applying a distraction force to the leg of the patient,distal portion 80 of adjustablehorizontal strut 30 can tend to lift upward relative to the floor, andgas shock assembly 345 can act to keepfoot 310 firmly engaging the floor, with a certain minimum amount of force (which can be varied by adjusting the gas shock force and overall travel). - Adjustable horizontal struts 30 also comprise bearing rails 99 (
FIGS. 15, 15A-15C, 16, 20 and 22-27 ) andgear racks 100 disposed ondistal portions 80 of adjustable horizontal struts 30. Bearing rails 99 andgear racks 100 serve as a means to selectively lock adjustablevertical struts 35 at a specific location alongdistal portions 80 of adjustablehorizontal struts 30 as will hereinafter be discussed. - Each of the adjustable vertical struts 35 (
FIGS. 1, 2, 16, 20, 22-29, 29A-29C and 30-33 ) comprises a lower portion 105 (FIG. 2 ), anintermediate portion 107, and anupper portion 110.Lower portions 105 comprise mounts 115 (FIG. 22 ) for adjustably securing adjustablevertical struts 35 to bearingrails 99 andgear racks 100 disposed ondistal portions 80 of adjustable horizontal struts 30. Lock/release mechanisms 120 (FIG. 24 ) are provided for locking/releasing adjustablevertical struts 35 at particular dispositions along bearingrails 99 andgear racks 100 disposed ondistal portions 80 of adjustable horizontal struts 30. Note that the lock/release mechanisms 120 are normally “locked” when in their “default” condition, such that mounts 115 andgear racks 100 prevent unintentional travel of adjustablevertical struts 35 along adjustablehorizontal struts 30, e.g., such as when performing a hip distraction. - In one preferred form of the invention, mounts 115 comprise bearings 121 (
FIG. 22 ) which roll along bearingrails 99, allowing adjustablevertical struts 35 to travel along the length ofdistal portions 80 of adjustable horizontal struts 30. This is for the purpose of allowing the user to adjust the positions of adjustablevertical struts 35 ondistal portions 80 of adjustablehorizontal struts 30 in order to provide different configurations for the distraction frame during a hip arthroscopy procedure (e.g., to flex or extend the leg of a patient). - Lock/
release mechanisms 120 are used to lock (or release) adjustablevertical struts 35 to (or from) adjustable horizontal struts 30. More particularly, lock/release mechanisms 120 each comprise a control 122 (FIGS. 24 and 25 ) which is used to engage/disengage a gear lock 123 (which is housed in mount 115) to/fromgear rack 100.Control 122 may be disposed within ahandle 124. In one embodiment, when control 122 (e.g., a trigger) is activated, a cable 125 (FIG. 25 ) is pulled which disengagesgear lock 123 from gear rack 100 (e.g., by pivoting alever 126 which pivotsgear lock 123 away from gear rack 100). A spring (not shown) returnsgear lock 123 back to its engaged state when control 122 (e.g., a trigger) is released, i.e., when lock/release mechanism 120 is in its “default” condition. -
Upper portions 110,intermediate portions 107 andlower portions 105 telescope relative to one another. Locking screws 127 (FIGS. 28 and 29 ) are provided to lockupper portions 110 relative tointermediate portions 107. If desired,upper portions 110 andintermediate portions 107 can be limited to discrete telescoping positions (e.g., to 5 discrete telescoping positions) orupper portions 110 andintermediate portions 107 can be continuously telescopically variable relative to one another.Handles 130 may be provided for lifting or loweringupper portions 110 andintermediate portions 107 of adjustablevertical struts 35 relative to lowerportions 105 of adjustablevertical struts 35. In one preferred form of the invention, and looking now atFIGS. 29A-29C ,rollers 128 are mounted tointermediate portions 107 and roll along the inner surfaces oflower portions 105. This provides low friction movement asintermediate portions 107 telescope relative to lowerportions 105. - In one form of the invention, gas shocks 132 (
FIG. 26 ) may be provided within the bodies oflower portions 105 of adjustablevertical struts 35 to help carry the loads ofupper portions 110 andintermediate portions 107 of adjustable vertical struts 35 (and any loads carried thereby, e.g., the leg of a patient). In one embodiment, gas shocks 132 are housed within inner lumens ofvertical struts 35, with one end ofgas shocks 132 being mounted to mount 115 and the other end ofgas shocks 132 being mounted tointermediate portions 107. However, it should be appreciated that gas shocks 132 may be used across all three portions of adjustable vertical struts 35 (i.e.,lower portions 105,intermediate portions 107 and upper portions 110), or between a pair ofportions 105/107/110, preferably betweenlower portions 105 andintermediate portions 107, but gas shocks 132 may also be used betweenupper portions 110 andintermediate portions 107. - By way of example but not limitation, where gas shocks 132 are provided to assist in adjusting the dispositions of
upper portions 110 andintermediate portions 107 of adjustablevertical struts 35, gas shocks 132 are configured to apply an upward force onintermediate portions 107 of adjustable vertical struts 35 (and hence onupper portions 110, which are connected to intermediate portions 107), andgas shocks 132 include lock mechanisms 133 (FIGS. 26 and 27 ) for lockinggas shocks 132 in a particular disposition. A button 134 (FIGS. 26 and 27 ) is depressed to disengagelock mechanism 133 such that gas shocks 132 are free to apply an upward force toupper portions 110 andintermediate portions 107 of adjustable vertical struts 35 (and any loads carried thereby) relative to lowerportion 105 of adjustablevertical struts 35. More particularly, the depression ofbutton 134 pushes arod 134A (FIGS. 26 and 27 ), which then pivots awheel 134B, which then pullscable 134C, which then lifts one end of afinger 135, whereby to force the other end offinger 135 to depresslock mechanism 133. Whenbutton 134 is released, a spring (not shown) biases the foregoing elements in the opposite direction so as to releaselock mechanism 133. - In lieu of a gas shock, alternative constructions may include springs or counter-weight systems to balance the loads carried by adjustable
vertical struts 35. - Hinge joints 137 (
FIGS. 1, 2 and 30-33 ) are disposed at the upper ends ofupper portions 110 of adjustablevertical struts 35.Distraction mechanisms 140 are mounted at the top ends ofupper portions 110 of adjustablevertical struts 35 via hinge joints 137.Universal joints 145 are disposed at the ends ofdistraction mechanisms 140.Mounts 150 are configured to releasably engagesurgical boots 20, such thatsurgical boots 20 can be releasably secured to distraction mechanisms 140 (and hence to distraction frame 5).Levers 155, disposed at the opposing ends ofdistraction mechanisms 140, are used by the user to operatedistraction mechanisms 140. More particularly, the user rotateslever 155 which, in turn, advances or retractsmount 150, and hence advances or retractssurgical boot 20.Distraction mechanisms 140 are of the sort well known in the art and generally comprise a mechanism which provides a significant mechanical advantage for the user. With this mechanical advantage, the user can apply a significant amount of distraction force to the leg of the patient. In one form of the invention,distraction mechanisms 140 comprise a force gauge 157 (FIGS. 30-33 ) which indicates the actual force being applied bydistraction mechanisms 140 to the leg of a patient. The user can, for example, minimize potential injury to the patient if the force does not exceed a certain threshold.Force gauge 157 may be mechanical (e.g., a simple “fish scale” device with lines and numbers) or electronic (e.g., with a digital readout). - In one preferred form of the invention, the various components of
distraction frame 5 are constructed so thatdistraction frame 5 can be “collapsed” into a compacted form, e.g., with adjustablehorizontal struts 30 being telescoped into a reduced length and with adjustablevertical struts 35 being telescoped into a reduced length; and with adjustablevertical struts 35 being disposed parallel to adjustablehorizontal struts 30; and withdistraction mechanisms 140 being disposed parallel to adjustablevertical struts 35 and adjustablehorizontal struts 30; and with L-shapedextensions 55 being inverted so that L-shapedbrackets 60 andadjustable supports 65 face upward and with L-shapedextensions 55 being reversed relative tobody 40 of table mount 25 so that L-shapedextensions 55 are set back over adjustable horizontal struts 30. In addition,wheels 230 oftable mount 25 are in their “down” position, and retractable foot pegs 97 of adjustablehorizontal struts 30 are in their “up” position so that adjustablehorizontal struts 30 rest oncastors 95, such thatdistraction frame 5 rides onwheels 230 andcastors 95. SeeFIGS. 34 and 35 . In this configuration,distraction frame 5 can be transported to another operating room or other location in the hospital (e.g., a storage location). Effectively, in this configuration,distraction frame 5 does not require a separate piece of equipment for mobility (e.g., a tote, a dolly, etc.). This provides significant convenience for the hospital staff. -
Distraction frame 5 is preferably used as follows. - First,
distraction frame 5 is assembled so that adjustablehorizontal struts 30 are mounted totable mount 25, adjustablevertical struts 35 are mounted to adjustablehorizontal struts 30, anddistraction mechanisms 140 are mounted toupper portions 110 of adjustable vertical struts 35 (if these components are not already mounted to one another). In addition, L-shapedextensions 55 are set so that L-shapedbrackets 60 andadjustable supports 65 face downward, and L-shapedextensions 55 are attached tobody 40 of table mount 25 so that L-shapedextensions 55 extend away from adjustable horizontal struts 30 (if these components are not already set in this position). - Then
distraction frame 5 is wheeled up to surgical table 10 onwheels 230 ofretractable wheel assembly 205 andcastors 95 of adjustablehorizontal struts 30, anddistraction frame 5 is assembled to surgical table 10 by mountingtable mount 25 tobase 15 of surgical table 10, e.g., by setting L-shapedextensions 55 on both sides ofbase 15 of surgical table 10, positioning L-shapedbrackets 60 beneathtable feet 62 of surgical table 10, retractingwheels 230 ofretractable wheel assembly 205 so thathorizontal surface 50 ofbody 40 seats on the floor, and then loweringfeet 62 of surgical table 10 onto L-shapedbrackets 60.Adjustable supports 65 are also adjusted as necessary to make secure contact to the floor. - Next,
distraction frame 5 is approximately configured for the size of the patient, the size of the surgeon, and the procedure to be conducted. This is done by setting the angles of adjustablehorizontal struts 30 relative to table mount 25 (and hence relative to surgical table 10), setting the lengths of adjustablehorizontal struts 30, setting the dispositions of adjustablevertical struts 35 on adjustablehorizontal struts 30, and setting the heights of adjustablevertical struts 35. - Then the patient's feet and legs are placed into, and secured to,
surgical boots 20.Surgical boots 20 are secured todistraction mechanisms 140 disposed at the top ends ofupper portions 110 of adjustablevertical struts 35. Further adjustments may be made todistraction frame 5 as necessary. - Distraction may occur with the surgical table set in a horizontal position or in an inclined position (e.g., with the patient in the so-called Trendelenburg position). For purposes of example but not limitation, distraction will now be discussed in the context of the patient having their leg distracted while in the Trendelenberg position.
- The patient is tilted on the surgical table to the Trendelenburg position. This is accomplished with the surgical table controls. Preferentially the amount of Trendelenburg angle is 15 degrees or less. To accommodate this change in patient position,
distraction frame 5 may be adjusted again as needed. In particular, the height of adjustablevertical struts 35 might be increased to maintain the patient in a planar position (relative to the table top) or with a small amount of hip flexion;horizontal struts 30 may then be adjusted so as to minimize distraction forces applied to the hip. It is also beneficial that during the application and removal of the Trendelenburg angle, lock/release mechanism 120 ofmount 115 is able to be maintained in an unlocked position. This allows for the change in angle relative todistraction frame 5 without putting undue stresses on the patient as the leg length changes relative to the horizontal plane of adjustablehorizontal strut 30. - Next,
distraction frame 5 is more precisely configured to begin the procedure to be conducted. This is done by more precisely setting the angles of adjustablehorizontal struts 30 relative to table mount 25 (and hence relative to surgical table 10), more precisely setting the dispositions of adjustablevertical struts 35 on adjustablehorizontal struts 30, and more precisely setting the heights of adjustablevertical struts 35, more precisely setting the length and angle of thedistraction mechanisms 140, and more precisely setting the angle ofsurgical boots 20. - The patient's hip may then be distracted by the surgical team by unlocking lock/
release mechanism 120 ofmount 115 and pulling distally on adjustablevertical struts 35, e.g., viahandle 124. From this starting position, at least 8 inches of travel along the horizontal struts 30 is provided for the surgical team to apply this pulling force to the patient. Then distraction mechanisms 140 (disposed at the top ends ofupper portions 110 of adjustable vertical struts 35) are adjusted as needed so as to apply the desired distraction force to the distal end of the patient's leg. From the starting position, at least 4 inches of additional travel is provided withindistraction mechanism 140 to apply force to the patient's leg. Any combination of these applications of traction is envisioned, as needed for the patient's treatment. - Once the patient's hip is appropriately distracted, a surgical procedure may then be conducted on the distracted hip.
- It should be appreciated that
distraction frame 5 of the present invention provides the ability to attain more C-arm positions than prior art distraction frames. This is due to the fact thatdistraction frame 5 mounts to base 15 of surgical table 10 and not to the end of the surgical table. Therefore, the space immediately undertable extender 23 and abovetable mount 25 and adjustablehorizontal struts 30 is open and allows the C-arm X-ray machine to be manipulated with a high degree of freedom. - It should also be appreciated that
distraction frame 5 of the present invention has 8 degrees of freedom: (1) gross traction extension/retraction (moving adjustablevertical struts 35 away from/toward the patient); (2) adduction/abduction of adjustablehorizontal struts 30 pivoting aboutbody 40; (3) adjustablevertical struts 35 raising and lowering; (4) distraction mechanisms 140 (fine traction) pivoting on adjustablevertical struts 35; (5) distraction mechanisms 140 (fine traction) retracting/advancing; and (6), (7) and (8)surgical boots 20 rotating and pivoting aboutuniversal joints 145. The 8 degrees of freedom provided bydistraction frame 5 are superior to the 3-5 degrees of freedom typically provided by the prior art, thereby providing the surgeon with the ability to position the patient's leg in a greater number of positions and orientations. This allows the surgeon to access anatomy that they could not previously be accessed with the distraction systems of the prior art. - The distraction frame of the present invention also allows for more deep flexion of the patient's hip due to the increased degrees of freedom provided by the distraction frame and due to the disassociation of the height of the distraction frame (where the patient's foot connects to the distraction frame) relative to the top of the surgical table. Because the patient's foot can be raised (by adjustment of the vertical struts) independently of the patient's horizontal position, additional flexion can be achieved by the distraction frame of the present invention.
- In addition to the foregoing, it should also be appreciated that
distraction frame 5 is able to accommodate a wide range of patient heights, i.e., from approximately 4′10″ to approximately 6′10″. This ability to accommodate a wide range of patient heights is due to the more numerous degrees of freedom combined with the adjustable nature of various components ofdistraction frame 5, e.g., the adjustability of adjustable horizontal struts 30. - Significantly, adjustable
vertical struts 35 can be positioned away from surgical table 10; this provides more space for the surgical staff to maneuver at the end of the table during surgical preparation, including while a patient is being transferred onto the surgical table. - It should also be appreciated that, in addition to manipulating
distraction frame 5 to effect hip distraction, the surgical table may also be manipulated to effect hip distraction. More particularly, and looking now atFIG. 36 , thebed 160 of surgical table 10 can typically be moved up/down, moved cephalad/caudal, tilted head-to-toe, and tilted side-to-side. If a patient is positioned onbed 160 of surgical table 10 and the patient's feet are attached todistraction frame 5, then movement ofbed 160 of surgical table 10 in a cephalad direction will have the same effect as applying tension to the leg by means of turninglevers 155 ofdistraction mechanisms 140 so as to move the foot in a caudal direction. - It should be appreciated that a patient can be in either a lateral decubitus position or a supine position on surgical table 10. In a lateral decubitus position, the patient lays on their side on the surgical table with the non-operative leg supported by the table and the operative leg supported by
distraction frame 5. In the supine position, the operative leg is supported bydistraction frame 5 and the non-operative leg would rest on surgical table 10 andtable extender 23. However,table extender 23 typically stops above the knee of the patient, so the non-operative leg has limited support. - To this end, in an alternative construction, one of adjustable
vertical struts 35 may replace its hinge joint 137,distraction mechanism 140,universal joint 145,mount 150,force gauge 157 andlever 155 with a leg board 165 (FIG. 37 ) which is mounted to one of the adjustable vertical struts. Since the non-operative leg sees no force during distraction and is typically not manipulated, the non-operative leg does not need to be secured todistraction frame 5 but can simply be supported byleg board 165. - It should also be appreciated that
distraction frame 5 may be used for orthopedic procedures other than hip arthroscopy, e.g.,distraction frame 5 may be used for hip trauma, total hip replacement, etc. - It should be understood that many additional changes in the details, materials, steps and arrangements of parts, which have been herein described and illustrated in order to explain the nature of the present invention, may be made by those skilled in the art while still remaining within the principles and scope of the invention.
Claims (22)
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US18/158,446 US20230157916A1 (en) | 2017-02-06 | 2023-01-23 | Distraction frame for effecting hip distraction |
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Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN110787019A (en) * | 2019-10-29 | 2020-02-14 | 北京市春立正达医疗器械股份有限公司 | Traction device and traction bed using same |
CN112618241A (en) * | 2021-01-04 | 2021-04-09 | 浙江省中医院 | Hip arthroscopy operation traction device |
US20220039764A1 (en) * | 2018-12-11 | 2022-02-10 | Siemens Healthcare Gmbh | Patient positioning device for an x-ray imaging apparatus |
WO2022104064A1 (en) * | 2020-11-12 | 2022-05-19 | Innovative Orthopedic Technologies, Iot Ag | Telescoping longitudinal femoral support systems |
US11382816B2 (en) | 2015-06-05 | 2022-07-12 | Stryker Corporation | Surgical table and accessories to facilitate hip arthroscopy |
US11395680B2 (en) * | 2019-09-04 | 2022-07-26 | The Third Hospital Of Hebei Medical University | Lower limb traction device for intramedullary nail implantation operation |
US11564855B2 (en) | 2020-09-28 | 2023-01-31 | Stryker Corporation | Systems and methods for supporting and stabilizing a patient during hip distraction |
US11684532B2 (en) | 2017-02-06 | 2023-06-27 | Stryker Corp. | Method and apparatus for supporting and stabilizing a patient during hip distraction |
Family Cites Families (189)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2732269A (en) | 1956-01-24 | Arm and leg support | ||
US2150314A (en) * | 1935-10-28 | 1939-03-14 | Gilbert Hyde Chick | Orthopedic apparatus |
US3220022A (en) * | 1963-12-23 | 1965-11-30 | Nelson Ted | Hospital bed sliding foot section |
US3745996A (en) * | 1971-02-19 | 1973-07-17 | Berivon Co | Apparatus for the reduction of bone fractures |
CH562015A5 (en) | 1972-03-21 | 1975-05-30 | Weinmann Ag | |
USD264531S (en) | 1980-02-12 | 1982-05-25 | Trode Varley P | Portable fish filleting table |
US4573482A (en) | 1982-07-02 | 1986-03-04 | Arthro-Medic, Inc. | Arthroscopic surgery method |
CH650387A5 (en) | 1982-12-27 | 1985-07-31 | Raichle Sportschuh Ag | SPORTSHOE, ESPECIALLY SKI SHOE. |
DE3317771A1 (en) | 1983-04-26 | 1984-10-31 | Weinmann Gmbh & Co Kg Fahrrad- Und Motorrad-Teilefabrik, 7700 Singen | SKI BOOT WITH CENTRAL LOCK |
US4708510A (en) | 1986-04-17 | 1987-11-24 | Mcconnell Bernard E | Ball joint coupling |
FR2608384B1 (en) | 1986-12-17 | 1989-05-05 | Salomon Sa | DEVICE FOR SETTING THE HEEL OF THE CARRIER'S FOOT IN A SKI SHOE |
CH672232A5 (en) | 1987-02-04 | 1989-11-15 | Lange Int Sa | |
US4865303A (en) | 1987-11-23 | 1989-09-12 | American Sterilizer Company | Operating table |
US5177882A (en) | 1989-06-03 | 1993-01-12 | Puma Ag Rudolf Dassler Sport | Shoe with a central fastener |
US5052128A (en) | 1989-07-24 | 1991-10-01 | Robert Lonardo | Padded boot means for invalid patients |
US5249377A (en) | 1990-01-30 | 1993-10-05 | Raichle Sportschuh Ag | Ski boot having tensioning means in the forefoot region |
US5162039A (en) | 1992-01-21 | 1992-11-10 | Dahners Laurence E | Distraction and reduction device |
US5306231A (en) | 1992-10-26 | 1994-04-26 | Harry Cullum | Traction system for a patient in a bed |
US5287575A (en) | 1992-11-09 | 1994-02-22 | Allen Medical Systems | Hand table |
US5582379A (en) | 1994-06-24 | 1996-12-10 | Allen Medical Systems | Adjustable limb support system |
US5560577A (en) | 1994-06-24 | 1996-10-01 | Allen Medical Systems | Adjustable limb support system |
US5608934A (en) | 1994-10-06 | 1997-03-11 | Smith & Nephew Dyonics, Inc. | Hip distractor |
KR100477282B1 (en) | 1995-03-01 | 2005-05-16 | 스미쓰 앤드 네퓨, 인크. | Spatial frame |
US5971984A (en) | 1995-03-01 | 1999-10-26 | Smith & Nephew, Inc. | Method of using an orthopaedic fixation device |
US5728095A (en) | 1995-03-01 | 1998-03-17 | Smith & Nephew, Inc. | Method of using an orthopaedic fixation device |
JP2764805B2 (en) | 1996-01-26 | 1998-06-11 | 株式会社シマノ | Back support for snowboard boots |
US5918330A (en) | 1996-08-14 | 1999-07-06 | Allen Medical Systems, Inc. | Ratchet mechanism for booted surgical stirrup |
USD385040S (en) | 1996-09-03 | 1997-10-14 | Allen Medical Systems | Boot for surgical stirrup |
USD389580S (en) | 1996-10-28 | 1998-01-20 | Allen Medical Systems | Surgical armboard |
USD387581S (en) | 1996-11-04 | 1997-12-16 | Just Wheels & Tire Co. | Wheel display stand |
US5802641A (en) | 1997-03-07 | 1998-09-08 | Amatech Corporation | Leg holder system for simultaneous positioning in the abduction and lithotomy dimensions |
US7591050B2 (en) | 1997-08-22 | 2009-09-22 | Boa Technology, Inc. | Footwear lacing system |
US6109625A (en) | 1998-03-13 | 2000-08-29 | Htc Products, Inc. | Mobile base |
US6286164B1 (en) | 1998-03-19 | 2001-09-11 | Orthopedic Systems, Inc. | Medical table having controlled movement and method of use |
US6162223A (en) | 1999-04-09 | 2000-12-19 | Smith & Nephew, Inc. | Dynamic wrist fixation apparatus for early joint motion in distal radius fractures |
AU2001234878A1 (en) | 2000-02-07 | 2001-08-14 | Hill-Rom Services, Inc. | Bariatric surface for an operating room table |
EP1460977B1 (en) | 2001-12-21 | 2006-08-30 | Smith & Nephew, Inc. | Hinged joint system |
SE524031C2 (en) | 2002-01-18 | 2004-06-15 | Bo Tillander | Device for fixing a patient, especially in hip surgery |
US7189214B1 (en) | 2002-01-22 | 2007-03-13 | The Saunders Group, Inc. | Multi-axis cervical and lumbar traction table |
AU2003217389B2 (en) | 2002-02-11 | 2008-10-30 | Smith & Nephew, Inc. | Image-guided fracture reduction |
JP4527929B2 (en) * | 2002-05-08 | 2010-08-18 | 衛 光石 | Reduction device |
US7341567B2 (en) * | 2002-09-10 | 2008-03-11 | D Amico Anthony T | Traction device for physical therapy |
US20040133983A1 (en) | 2003-01-13 | 2004-07-15 | Newkirk David C. | Surgical table |
US20040133979A1 (en) | 2003-01-13 | 2004-07-15 | Newkirk David C. | Orthopedic table apparatus |
US7677249B2 (en) | 2003-04-16 | 2010-03-16 | The University Of Hong Kong | Device and method for providing a lateralization effect |
JP4520710B2 (en) * | 2003-05-22 | 2010-08-11 | 衛 光石 | Power assist control device, power assist control method, and reduction device |
US7862570B2 (en) | 2003-10-03 | 2011-01-04 | Smith & Nephew, Inc. | Surgical positioners |
US7337483B2 (en) | 2004-01-23 | 2008-03-04 | Allen Medical Systems, Inc. | Surgical positioning apparatus |
CA2561493A1 (en) | 2004-03-31 | 2005-10-20 | Smith & Nephew, Inc. | Methods and apparatuses for providing a reference array input device |
EP1737375B1 (en) | 2004-04-21 | 2021-08-11 | Smith & Nephew, Inc | Computer-aided navigation systems for shoulder arthroplasty |
DE102004025612A1 (en) | 2004-04-22 | 2005-11-10 | Plus Endoprothetik Ag | Device for detecting a force-displacement characteristic of one or more bands, as well as methods for detecting the characteristic |
US7211056B2 (en) | 2004-08-28 | 2007-05-01 | Danuta Grazyna Petelenz | Device for chest and abdominal compression CPR |
US8388553B2 (en) | 2004-11-04 | 2013-03-05 | Smith & Nephew, Inc. | Cycle and load measurement device |
US20060100562A1 (en) | 2004-11-09 | 2006-05-11 | Pamplin James C | Hip distraction system |
US7669262B2 (en) | 2004-11-10 | 2010-03-02 | Allen Medical Systems, Inc. | Accessory frame for spinal surgery |
US7520008B2 (en) | 2004-11-10 | 2009-04-21 | Allen Medical Systems | Surgical table extension |
US7520007B2 (en) | 2004-11-10 | 2009-04-21 | Allen Medical Systems, Inc. | Accessory rail clamp with latch and lock mechanisms |
US7882583B2 (en) | 2004-11-10 | 2011-02-08 | Allen Medical Systems, Inc. | Head support apparatus for spinal surgery |
US7600281B2 (en) | 2004-11-10 | 2009-10-13 | Allen Medical Systems, Inc. | Body support apparatus for spinal surgery |
DE102004054332A1 (en) | 2004-11-10 | 2006-05-11 | Memminger, Michael, Dr. | Leg guide, in particular for use in hip surgery |
WO2006066116A2 (en) | 2004-12-17 | 2006-06-22 | Steelcase Development Corporation | Height adjustable table |
US8707484B2 (en) | 2005-02-22 | 2014-04-29 | Roger P. Jackson | Patient positioning support structure |
US8055487B2 (en) | 2005-02-22 | 2011-11-08 | Smith & Nephew, Inc. | Interactive orthopaedic biomechanics system |
US9849054B2 (en) | 2005-02-22 | 2017-12-26 | Roger P. Jackson | Patient positioning support structure |
US9295433B2 (en) | 2005-02-22 | 2016-03-29 | Roger P. Jackson | Synchronized patient elevation and positioning apparatus for use with patient positioning support systems |
US9301897B2 (en) | 2005-02-22 | 2016-04-05 | Roger P. Jackson | Patient positioning support structure |
US9308145B2 (en) | 2005-02-22 | 2016-04-12 | Roger P. Jackson | Patient positioning support structure |
US20150059094A1 (en) | 2005-02-22 | 2015-03-05 | Roger P. Jackson | Patient positioning support structure |
US20140033434A1 (en) | 2005-02-22 | 2014-02-06 | Roger P. Jackson | Cantilevered patient positioning support structure |
US7739762B2 (en) | 2007-10-22 | 2010-06-22 | Mizuho Orthopedic Systems, Inc. | Surgery table apparatus |
US9744087B2 (en) | 2005-02-22 | 2017-08-29 | Roger P. Jackson | Patient support apparatus with body slide position digitally coordinated with hinge angle |
US9468576B2 (en) | 2005-02-22 | 2016-10-18 | Roger P. Jackson | Patient support apparatus with body slide position digitally coordinated with hinge angle |
US8844077B2 (en) | 2005-02-22 | 2014-09-30 | Roger P. Jackson | Syncronized patient elevation and positioning apparatus positioning support systems |
US9265679B2 (en) | 2005-02-22 | 2016-02-23 | Roger P Jackson | Cantilevered patient positioning support structure |
US9186291B2 (en) | 2005-02-22 | 2015-11-17 | Roger P. Jackson | Patient positioning support structure with trunk translator |
US7565708B2 (en) | 2005-02-22 | 2009-07-28 | Jackson Roger P | Patient positioning support structure |
US7152261B2 (en) | 2005-02-22 | 2006-12-26 | Jackson Roger P | Modular multi-articulated patient support system |
DE102005023477A1 (en) | 2005-04-28 | 2006-11-09 | Plus Orthopedics Ag | Device to be used for positioning of leg of patient during minimal-invasive hip transplant operation, comprises facilities for horizontal and vertical adjustment |
US20060271056A1 (en) | 2005-05-10 | 2006-11-30 | Smith & Nephew, Inc. | System and method for modular navigated osteotome |
KR101336214B1 (en) | 2005-08-10 | 2013-12-04 | 미주호 오서피딕 시스템즈, 아이엔씨. | Medical table having controlled movement and method of use |
EP1924211B1 (en) | 2005-08-23 | 2019-12-18 | Smith & Nephew, Inc. | Telemetric orthopaedic implant |
US7832401B2 (en) | 2005-11-30 | 2010-11-16 | Smith & Nephew, Inc. | Hip distraction |
US7947006B2 (en) | 2005-11-30 | 2011-05-24 | Smith & Nephew, Inc. | Hip distraction |
CA2646061C (en) | 2006-03-20 | 2014-06-17 | Smith & Nephew, Inc. | Acetabular cup assembly for multiple bearing materials |
US7949386B2 (en) | 2006-03-21 | 2011-05-24 | A2 Surgical | Computer-aided osteoplasty surgery system |
USD546599S1 (en) | 2006-04-10 | 2007-07-17 | Global Equipment Company, Inc. | Portions of a right side shelf and cabinet drawer |
USD665912S1 (en) | 2006-04-11 | 2012-08-21 | Allen Medical Systems, Inc. | Head support pad for surgery |
US20070277350A1 (en) | 2006-06-05 | 2007-12-06 | Stephen Hines | Leveling caster system and method of using same |
US8011045B2 (en) | 2006-06-12 | 2011-09-06 | Allen Medical Systems, Inc. | Localized patient support |
US8037884B2 (en) | 2006-10-02 | 2011-10-18 | Allen Medical Systems, Inc. | Modular system for patient positioning during medical procedures |
US7949006B2 (en) | 2006-11-09 | 2011-05-24 | Motorola Mobility, Inc. | System and method for media burst control of discrete content for push-to-cellular communication |
US7650654B2 (en) | 2007-03-05 | 2010-01-26 | Stryker Corporation | Transfer device |
US8128117B2 (en) | 2007-06-14 | 2012-03-06 | Flow Sports, Inc. | Tool-free adjustable binding for sports board |
EP2002796B1 (en) | 2007-06-15 | 2012-08-08 | BrainLAB AG | Computer-assisted planning method for correcting changes to the shape of bones in joints |
IL184151A0 (en) | 2007-06-21 | 2007-10-31 | Diagnostica Imaging Software Ltd | X-ray measurement method |
US7913336B2 (en) | 2007-08-14 | 2011-03-29 | Stryker Corporation | Shearless pivot for bed |
JP2010536535A (en) | 2007-08-24 | 2010-12-02 | アレン メディカル システムズ インコーポレイテッド | Operating table accessory platform |
CN101953021A (en) | 2007-09-06 | 2011-01-19 | 史密夫和内修有限公司 | Be used for the system and method for communicating by letter with the remote measurement implant |
WO2009062545A1 (en) | 2007-11-13 | 2009-05-22 | Schaerer Mayfield Medical Ag | Modular device for positioning and immobilisation of a patient's body for surgical operations and corresponding operating table |
EP2234554B1 (en) | 2007-12-06 | 2018-10-10 | Smith & Nephew, Inc. | Method for determining the mechanical axis of a femur |
WO2009108683A1 (en) | 2008-02-25 | 2009-09-03 | Smith & Nephew, Inc. | Method and system of mapping femoral head for acetabular prosthesis alignment |
CN102026594B (en) | 2008-05-15 | 2013-12-25 | 欧苏尔公司 | Orthopedic devices utilizing rotary tensioning |
US8322342B2 (en) | 2008-07-25 | 2012-12-04 | Allen Medical Systems, Inc. | Operative arm support |
BRPI0920250A2 (en) | 2008-10-15 | 2016-11-22 | Smith & Nephew Inc | composite internal fasteners |
DE202008014021U1 (en) | 2008-10-21 | 2009-02-12 | Condor Gmbh Medicaltechnik | Pull and turntable, especially for hip endoprosthetics and trauma surgery |
TW201034646A (en) | 2009-03-17 | 2010-10-01 | Amtai Medical Equipment Co Ltd | Operating table |
US8690806B2 (en) | 2009-09-02 | 2014-04-08 | Allen Medical Systems, Inc. | Surgical positioning system |
US8690807B2 (en) | 2009-09-02 | 2014-04-08 | Allen Medical Systems, Inc. | Surgical positioning system |
US8469911B2 (en) | 2009-09-02 | 2013-06-25 | Eugene Lloyd Hiebert | Surgical positioning system |
DE102009047869B4 (en) | 2009-09-30 | 2014-06-05 | Maquet Gmbh & Co. Kg | Adapter for connecting at least one accessory to an operating table and system comprising an operating table, at least one accessory and an adapter |
EP2512393B1 (en) | 2009-12-14 | 2017-09-13 | Hill-Rom Services, Inc. | Patient support apparatuses with exercise functionalities |
US9526349B2 (en) | 2009-12-17 | 2016-12-27 | Stryker Corporation | Patient support cover |
US8707486B2 (en) | 2010-02-16 | 2014-04-29 | Allen Medical Systems, Inc. | Lacing system to secure a limb in a surgical support apparatus |
US8833707B2 (en) | 2010-07-15 | 2014-09-16 | Allen Medical Systems, Inc. | Disposable urology drainage bag |
CN103179922B (en) | 2010-08-26 | 2016-08-17 | 史密夫和内修有限公司 | Implant, surgical method and the apparatus of operation is clashed into for femur acetabular bone |
US10130542B1 (en) | 2010-09-17 | 2018-11-20 | Glenn Gerald Strawder | Device for positioning the neck of a person in the flexion and extension positions |
US20120073476A1 (en) | 2010-09-28 | 2012-03-29 | Hsiu-Chen Lai | Drop leaf table angular adjustment mechanism |
CN103442650A (en) | 2010-11-12 | 2013-12-11 | 史密夫和内修有限公司 | Inflatable, steerable balloon for elevation of tissue within a body |
US8806679B2 (en) | 2010-11-18 | 2014-08-19 | Allen Medical Systems, Inc. | Operating room table adapter |
US8555439B2 (en) | 2010-11-18 | 2013-10-15 | Allen Medical Systems, Inc. | Padded head support |
US8893333B2 (en) | 2010-11-18 | 2014-11-25 | Allen Medical Systems, Inc. | Surgical head support apparatus |
US9072646B2 (en) | 2010-12-14 | 2015-07-07 | Allen Medical Systems, Inc. | Lateral surgical platform with rotation |
WO2012103169A2 (en) | 2011-01-25 | 2012-08-02 | Smith & Nephew, Inc. | Targeting operation sites |
EP2484315B1 (en) | 2011-02-07 | 2014-06-11 | Arthrex, Inc. | Minimally invasive total hip replacement |
DE202011000308U1 (en) | 2011-02-10 | 2011-04-21 | Maquet Gmbh & Co. Kg | extension device |
US9636248B2 (en) | 2011-03-11 | 2017-05-02 | Innovative Orthopedic Technologies, Llc | Devices and methods for supporting a patient's legs |
US20120240938A1 (en) | 2011-03-21 | 2012-09-27 | Christo Pamichev | Methods and systems for performing hip joint distraction |
US8584281B2 (en) | 2011-04-07 | 2013-11-19 | Mizuho Orthopedic Systems, Inc | Surgery table having coordinated motion |
DE102011016456B4 (en) | 2011-04-08 | 2016-02-25 | Condor Gmbh Medicaltechnik | positioning |
US9173649B2 (en) | 2011-04-08 | 2015-11-03 | Allen Medical Systems, Inc. | Low profile distractor apparatuses |
US8845568B2 (en) | 2011-04-08 | 2014-09-30 | Allen Medical Systems, Inc. | Distractor straps for use with distractor apparatuses |
US9655764B2 (en) | 2011-06-02 | 2017-05-23 | Allen Medical Systems, Inc. | Surgical foot support with handles |
GB201115391D0 (en) | 2011-09-06 | 2011-10-19 | Wootton Malcolm | Operating tables and accessories |
EP3165112B1 (en) | 2011-09-15 | 2023-11-08 | NB NewBoots SA | Sports boot |
US8986228B2 (en) | 2011-09-19 | 2015-03-24 | Trimanus Medical, Inc. | Method and apparatus for monitoring surgical traction |
US8997749B2 (en) | 2011-09-30 | 2015-04-07 | Allen Medical Systems, Inc. | Surgical assembly |
WO2013081641A1 (en) | 2011-11-28 | 2013-06-06 | Jackson Roger P | Patient positioning support structure with coordinated continuous nonsegmented articulation, rotation and lift, and locking fail-safe device |
WO2013106426A2 (en) | 2012-01-10 | 2013-07-18 | Pigazzi Alessio | A method of securing a patient onto an operating table when the patient is in the trendelenburg position and apparatus therefor including a kit |
US8464720B1 (en) | 2012-01-10 | 2013-06-18 | Alessio Pigazzi | Method of securing a patient onto an operating table when the patient is in the trendelenburg position and apparatus therefor including a kit |
US8511314B2 (en) | 2012-01-10 | 2013-08-20 | Khs Gmbh | Method of securing a patient onto an operating table when the patient is in the Trendelenburg position and apparatus therefor including a kit |
NL2008437C2 (en) | 2012-01-19 | 2013-07-22 | Clinical Graphics B V | Process to generate a computer-accessible medium comprising information on the functioning of a joint. |
US10206842B2 (en) | 2012-01-26 | 2019-02-19 | American Sterilizer Company | Medical table with leg support |
US9468577B2 (en) | 2012-02-06 | 2016-10-18 | Arthrex, Inc. | Perineal post pad for patient lower extremity positioning systems |
WO2013119688A1 (en) | 2012-02-06 | 2013-08-15 | Stefan Kreuzer | Surgical table with moveable perineal post |
DE112013000875T5 (en) | 2012-02-07 | 2014-10-16 | Arthrocare Corporation | Surgical instrument for laying and performing a suture |
US9265680B2 (en) | 2012-03-06 | 2016-02-23 | Operating Room Safety Enterprises, LLC | Surgical table |
US8997281B2 (en) | 2012-03-23 | 2015-04-07 | Trumpf Medizin Systeme Gmbh + Co. Kg | Operating table top assemblies and related devices |
DE202012101347U1 (en) | 2012-04-13 | 2012-06-27 | Condor Gmbh Medicaltechnik | positioning |
US9498397B2 (en) | 2012-04-16 | 2016-11-22 | Allen Medical Systems, Inc. | Dual column surgical support system |
US20140173827A1 (en) | 2012-04-23 | 2014-06-26 | HUG-A-VAC Surgical Positioning Systems, Inc. | Patient positioning system |
WO2013181531A1 (en) | 2012-06-01 | 2013-12-05 | Joseph Gauta | Portable stirrup with leg support |
US20130338792A1 (en) | 2012-06-15 | 2013-12-19 | Arthrex, Inc. | Implantation of micronized allograft tissue over a microfractured defect |
DE102012105264B4 (en) | 2012-06-18 | 2016-06-09 | MAQUET GmbH | Device for fixing a femur in hip endoprosthesis |
US9522095B2 (en) | 2012-06-22 | 2016-12-20 | Carl W. Steele | Devices for mobilizing the hip joint capsule and methods of using same |
US9107792B2 (en) | 2012-09-07 | 2015-08-18 | Allen Medical Systems, Inc. | Carriage for a surgical boot of a hip distractor |
US9161875B2 (en) | 2012-09-07 | 2015-10-20 | Allen Medical Systems, Inc. | Multi-axis joint for a spar of a limb holder |
EP2895132B8 (en) | 2012-09-13 | 2017-08-23 | Innovative Orthopedic Technologies, LLC | Telescoping and elevating femoral support |
ITMI20121548A1 (en) | 2012-09-18 | 2014-03-19 | Medacta Int Sa | APPARATUS FOR POSITIONING THE LOWER ARTH OF A PATIENT IN OPERATIVE OFFICE, IN PARTICULAR FOR REPLACEMENT OPERATIONS OF THE ANCHOR WITH A FRONT APPROACH, AND A SURGICAL POSITIONING SYSTEM INCLUDING THE APPLIANCE |
ITMI20121546A1 (en) | 2012-09-18 | 2014-03-19 | Medacta Int Sa | ADAPTER FLOOR FOR SURGICAL TABLE, IN PARTICULAR FOR REPLACEMENT OPERATIONS OF THE HOOK WITH FRONT APPROACH |
US8997284B2 (en) | 2012-11-15 | 2015-04-07 | Innovative Orthopedic Technologies, Llc | Surgical table with pivotable femoral support |
US8944065B2 (en) | 2013-03-22 | 2015-02-03 | Smith & Nephew, Inc. | Boot with lockable strap |
WO2014176418A2 (en) | 2013-04-24 | 2014-10-30 | Visco Anthony G | Patient stabilization device and methods of use |
US10022259B2 (en) | 2013-04-24 | 2018-07-17 | Pivot Medical, Inc. | Apparatus and method for distracting the hip joint |
US9331262B2 (en) | 2013-05-20 | 2016-05-03 | Tdk Corporation | Thin film piezoelectric element, thin film piezoelectric actuator, thin film piezoelectric sensor, hard drive disk, and inkjet printer device |
WO2014194224A2 (en) | 2013-05-30 | 2014-12-04 | Prime Medical, LLC | Operating room table pad |
US9353561B2 (en) | 2013-06-10 | 2016-05-31 | Ronnie GAENZLE | 180 degree foldable locking hinge |
US9375343B2 (en) | 2013-06-18 | 2016-06-28 | Covidien Lp | Patient positioning system |
US20150008201A1 (en) | 2013-07-02 | 2015-01-08 | Whitmor, Inc. | Folding garment rack |
EP3025305B1 (en) | 2013-07-25 | 2019-09-04 | Smith&Nephew, Inc. | Method for creating a surgical resection plan for treating a pathological deformity of a bone |
WO2015048265A1 (en) | 2013-09-25 | 2015-04-02 | Ossur Hf | Orthopedic device |
EP2873405B1 (en) | 2013-11-18 | 2016-05-18 | Schaerer Medical Management AG | Modular operating table |
US20150196447A1 (en) | 2014-01-13 | 2015-07-16 | Athello, Inc. | Lower Extremity Positioning Assembly And Table Extension |
US9085915B1 (en) | 2014-03-06 | 2015-07-21 | Troy Emmett | Wooden support post protection system |
US20160279007A1 (en) | 2014-03-28 | 2016-09-29 | Gerald J. Flatt | Patient positioning support |
DE102014108745A1 (en) | 2014-06-23 | 2015-12-24 | MAQUET GmbH | Device for the self-locking bidirectional drive of a medical treatment device |
JP5754680B1 (en) | 2014-07-29 | 2015-07-29 | サージカルアライアンス株式会社 | Traction operating table for lower limb joint surgery, connection mat unit, and traction operating table installation / storage system for lower limb joint surgery |
US10675203B2 (en) | 2014-10-07 | 2020-06-09 | Allem Medical Systems, Inc. | Sterile limb connectors and methods |
US20160120720A1 (en) | 2014-10-31 | 2016-05-05 | Children's Hospital Medical Center | Patient support coupled medical accessory support |
US10188573B2 (en) * | 2014-11-05 | 2019-01-29 | Allen Medical Systems, Inc. | Boot stirrup |
US20160184154A1 (en) | 2014-12-31 | 2016-06-30 | Stryker Corporation | Support surface system |
US20160287461A1 (en) | 2015-04-01 | 2016-10-06 | Michael L. Naughton | Surgical table with combination footboard and patient transfer board |
US10350020B2 (en) | 2015-05-01 | 2019-07-16 | Chris Geiger | Medical tray assembly |
US10058325B2 (en) | 2015-05-19 | 2018-08-28 | Arthrex, Inc. | Suture passer and method of tissue repair |
US11382816B2 (en) * | 2015-06-05 | 2022-07-12 | Stryker Corporation | Surgical table and accessories to facilitate hip arthroscopy |
USD832334S1 (en) | 2017-01-18 | 2018-10-30 | Bandlab Technologies | Pedal board |
US11684532B2 (en) | 2017-02-06 | 2023-06-27 | Stryker Corp. | Method and apparatus for supporting and stabilizing a patient during hip distraction |
CA3052788A1 (en) | 2017-02-06 | 2018-08-09 | Stryker Corp. | Anatomical gripping system for gripping the leg and foot of a patient when effecting hip distraction and/or when effecting leg positioning |
US10034806B1 (en) | 2017-05-24 | 2018-07-31 | Samuel Greenhalgh, Sr. | Over-bed table organizer |
US11564855B2 (en) | 2020-09-28 | 2023-01-31 | Stryker Corporation | Systems and methods for supporting and stabilizing a patient during hip distraction |
-
2018
- 2018-02-06 EP EP18747404.4A patent/EP3576684A4/en active Pending
- 2018-02-06 AU AU2018215696A patent/AU2018215696A1/en not_active Abandoned
- 2018-02-06 CA CA3052793A patent/CA3052793A1/en not_active Abandoned
- 2018-02-06 WO PCT/US2018/017099 patent/WO2018145108A1/en active Application Filing
- 2018-02-06 US US15/890,124 patent/US11559455B2/en active Active
-
2023
- 2023-01-23 US US18/158,446 patent/US20230157916A1/en active Pending
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Also Published As
Publication number | Publication date |
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EP3576684A1 (en) | 2019-12-11 |
CA3052793A1 (en) | 2018-08-09 |
US20230157916A1 (en) | 2023-05-25 |
WO2018145108A1 (en) | 2018-08-09 |
US11559455B2 (en) | 2023-01-24 |
AU2018215696A1 (en) | 2019-08-29 |
EP3576684A4 (en) | 2020-12-02 |
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